So, I went to a local optometrist who has some specialized training in dry eye stuff, and in addition to both my right puncta being too large from my punctal snip, he also diagnosed me with low meniscus in my right eye, low TBUT (5 or 6) in both eyes, and MGD in both eyes (toothpasty secretions in some glands a 2-3 on a 1-4 scale). He prescribed restasis ($258 for a 30 day supply AFTER my insurance kicked in a generous $25!), warm compress massages, and eyelid margin scrubs with ocusoft.
Although I'm bummed to find out that my "good" eye has issues too, I'm glad I'm with someone who seems to know what he's doing. Our current plan is to start the lid hygiene regime and restasis now, and in three months when my punctal snips are 100% healed and have no chance of further tightening, insert a 30-day dissolvable plug in the bad eye's lower punctum. If the plug helps, he will refer me for cautery of lower punctum (because he thinks my snipped puncta are too large for an umbrella plug to stay in).
Could I please get some feedback on the following?
1. Since I started with the ocusoft lid margin cleaning, my right eye lower lid margin has been really itchy...like, I'll have to scratch it with my fingernail right on the lashline to relieve the itch. I'm not sure if it's the Ocusoft causing this, or if an undiagnosed seasonal allergy has kicked in, or what. I do recall having the same eyelid margin itchiness in the past (long before Ocusoft and dry eye days), and it's in the same part of my lid margin that I have a notch from an atrophied meibomian gland. Any insight?
2. Does this doctor's proposed game-plan sound reasonable, or do you see any red flags?
3. If restasis helps, I'd like to pursue a compounded version, both because of cost and because I saw the study on the castor oil being cytotoxic. Any leads on where I should go for this? I'm in Wisconsin.
Although I'm bummed to find out that my "good" eye has issues too, I'm glad I'm with someone who seems to know what he's doing. Our current plan is to start the lid hygiene regime and restasis now, and in three months when my punctal snips are 100% healed and have no chance of further tightening, insert a 30-day dissolvable plug in the bad eye's lower punctum. If the plug helps, he will refer me for cautery of lower punctum (because he thinks my snipped puncta are too large for an umbrella plug to stay in).
Could I please get some feedback on the following?
1. Since I started with the ocusoft lid margin cleaning, my right eye lower lid margin has been really itchy...like, I'll have to scratch it with my fingernail right on the lashline to relieve the itch. I'm not sure if it's the Ocusoft causing this, or if an undiagnosed seasonal allergy has kicked in, or what. I do recall having the same eyelid margin itchiness in the past (long before Ocusoft and dry eye days), and it's in the same part of my lid margin that I have a notch from an atrophied meibomian gland. Any insight?
2. Does this doctor's proposed game-plan sound reasonable, or do you see any red flags?
3. If restasis helps, I'd like to pursue a compounded version, both because of cost and because I saw the study on the castor oil being cytotoxic. Any leads on where I should go for this? I'm in Wisconsin.
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