Travel and Dry Eyes (Yes, You Can Even Go to Developing Countries and Survive!)

[tealeaf]

SAAG,
This morning doctor removed 1 umbrella plug from my worse eye (which was double plugged) as that area becomes red and slightly inflammed. He said let the inflammation cool off then decide the next course. He suggested to do cautery to that tear duct. I need your advise. I had double plugged on my worse eye 2+ weeks ago and throughout this period, that eye had overflow, say twice in an hour. Though I do not like the weeping feeling, I reckon more tears is better than less. Overall, it was more comfortable. Should I go for cautery? What will happen if it reopens? Re-cautery? I read in this forum that some people had cautery and after it re-opened, the tear duct was being probed to put in a plug. Is so confusing. Any advise please.

[Guest]

SAAG,
He suggested to do cautery to that tear duct. I need your advise. I had double plugged on my worse eye 2+ weeks ago and throughout this period, that eye had overflow, say twice in an hour. Though I do not like the weeping feeling, I reckon more tears is better than less. Overall, it was more comfortable. Should I go for cautery?

Well, what I chose for myself, with no regrets, was cautery. Any overflow is well-worth it to me for the increase in comfort that I get from it.

Of course, I can't say for sure how YOU will feel about the trade-off. If it means you are suddenly able to be more productive (as I am), more comfortable (as I am), you may not care about the overflow since you'll see it as a small price to pay for the benefits you are getting.

Or you may be one of those people who despise the overflow so much that you end up feeling like you traded one problem for another that is just as bad. Prior to doing it (if that's what you choose), just be really sure of what YOU think is the lesser evil (overflow with cautery, or dryer eyes without cautery)

And keep in mind the possibility that your eyes will improve with time, in which case the weeping could get worse (and obviously your eye comfort should be better as well) - I'm fine with this possibility (it's the lesser evil as far as I'm concerned), you may feel differently.

Lastly, weigh the risk of serious complications from cautery (rare, if your doctor knows what he/she is doing) vs. the potential increase in ocular comfort and productivity from cautery vs. the inconvenience of overflow from cautery. Ultimately, all you can do is make an educated guess and play the odds, right?

Not unlike deciding to drive a car (risk of getting killed in an accident vs. the desire to get to your destination quickly and efficiently).

Not unlike choosing to eat solid food (risk of choking on your food any dying vs. the fact that a pureed diet would really suck).

Ok, so I get that those examples are far from a perfect comparison, but my point is, we make choices based on the likelihood of risk vs. benefit all the time, and the choice whether or not to have cautery is just one more of those, right?

What will happen if it reopens? Re-cautery?

Yes, as I understand it, re-cautery is the most common course of action if this occurs. My upper right puncta stayed shut after only one try. My upper left puncta took 3 tries. My bottom puncta each required 2 tries to stay shut.

I read in this forum that some people had cautery and after it re-opened, the tear duct was being probed to put in a plug. Is so confusing. Any advise please.

The impression I was given by the ophthamologists I've seen for this is that if it re-opens the best choice is to just re-cauterize it. I honestly don't know why someone would opt to have them dig around in there with a probe to insert a plug... maybe someone else here would know? I assume whoever needed to have it probed and whatever must have had an unusual situation? Or maybe they hated the cautery procedure so much that they didn't want to do it again??

[RFREITAS]

Routine

Hello SAAG!

I hope you are having fun in Asia.

I would like to ask you what are your major sympthoms at the moment. It's possible to describe your current routine?
I am asking that because some of my sympthoms have changed a lot during this last year. Now I feel my eyes full... like if I touch them they will explode. Also I have pain around them... never had this before.

Also your nax drops are for which sympthom?

Sorry my poor english!!

[tealeaf]

Hi SAAG,
Thank you, as always, for your detailed explanation

Doctor said will review me in a month's time, till then, I will decide whether to put in another umbrella plug or go for cautery. Actually, I don't think I can endure for 1 whole month with only 1 plug in the worse eye ... hmm
I may cauterise only 1 puncta for a start. This whole Lasik ordeal is making me less of a risk taker.

I wonder how do you manage to keep the plug in for 5 good years ... is only 8 months for me and already the corner of the eye gets infected and itchy.

And keep in mind the possibility that your eyes will improve with time, in which case the weeping could get worse (and obviously your eye comfort should be better as well) - I'm fine with this possibility (it's the lesser evil as far as I'm concerned), you may feel differently.

I really like your positive attitude. At times, I wonder how much will the eye improve with time ...

Yes, as I understand it, re-cautery is the most common course of action if this occurs. My upper right puncta stayed shut after only one try. My upper left puncta took 3 tries. My bottom puncta each required 2 tries to stay shut.

I remember you had your bottom puncta closed in Penang. How long did they stay close before opened up? Did they opened up fully or abit?

By the way, post lasik, do you have problem with floaters?

[Guest]

I wonder how do you manage to keep the plug in for 5 good years ... is only 8 months for me and already the corner of the eye gets infected and itchy.

It's hard to say. I suppose it's likely because I had a good fit to start with.

And maybe the fact that I generally did not touch my eyes to scratch, rub etc. ever?? I was very concerned about the risk of infection, so figured the less I touch my eye area, the less potential to introduce bacteria that could lead to problems. I'd use a clean tissue if I had to blot tears, would not wipe them away with my fingers.

[RFREITAS]

Oh I believe so. However I have been taking magnesium and I am feeling better. To soon to realize if the magnesium is helping or not...

SAAG, have you been diagnized with neuropathic pain ?

Hope you are having fun!


Tealeaf I also have floaters... but have been learning to deal with this. Doesn't hurt... so it's (more or less) ok!

[tealeaf]

SAAG,
I had been busy for the past few weeks and also trying to see if my eyes can make do with just 1 plug on each eye. Dissappointment. Will give plug another try before cautery.

With all punctum closed and years of taking care of your eyes, do you find your eyes comfort increased to a level which is tolerable and not giving them tons of focus?

Are you still staying in SE Asia or back in Canada?

RFREITAS,
Do you see floaters only after LASIK? What do you tell yourself when you see them?
I have floaters and can see them at work or outside. But see more in bright daylight. Am also trying to manage them.

[tealeaf]

SAAG,

I have cauterised one of my punctums in my worse eye, thus this eye has 1 upper umbrella plug and 1 lower cautery. Today is the 3rd day post cautery, however, I can still feel small amount of drops going into my punctum when I applied eye drops. Doctor said the wound will take about a week to heal, then will know whether it is completely closed. Did you experience the same or your punctum is tightly closed staright after cautery?

Thanks!!

[RFREITAS]

Hello Tealeaf

Hope you are doing well.

About the floaters... it was hard to deal at first. But someone told that he has it too and he is able to see, to read, to work... so on!
So I start to do that. When they bother me I think I can do everything... also my doctor told me he has many!
So with time it gets better!

But actualy what really helped me was thinking if I prefer dry eyes or floaters! easy answer ) So now I am more confortable, I wear sunglasses outsider and I try to Forget that I have them! I have more to worry about ahahah I hope it helps!

Happy Easter!

[Guest]

With all punctum closed and years of taking care of your eyes, do you find your eyes comfort increased to a level which is tolerable and not giving them tons of focus?

I'll always have to focus on my eyes, I don't think that will ever change. Mind you, that says nothing about what your experience will be - everyone is different, right?

[tealeaf]

RFREITAS,

Indeed, my eye doctor said he has many too since he had a big retina tear sometime back. My colleague has torn her retina too and saw many floaters and they all got on with life.
I feel much better after reading your message. Thank you so much for your kind and comforting message.

[tealeaf]

SAAG,
I have my two lower punctum cauterised. Doctor said they are already completely shut, have yet to verify it myself

My worse eye has 1 upper umbrella plug and lower cautery. It's a month since. There is overflow but within my comfort level. My better eye has lower cautery and 1 temporary plug which is not that helpful. I am thinking to plug the upper as well, however, I am relying on this eye to see as the overflow in the other eye is obstructing my vision at times. Is a dilemma.

Hope the humid weather in SEAsia will continue to bring healing to your eyes.

[neilw]

Your year in SE Asia

SAAG
I notice that you have been in SE Asia for about a year now and see from another post of yours that your eyes have really improved in your time there. I'd like to ask a few questions if I could. I have asked these earlier so I am really after your current opinions after spending more time there.

• Did you end up staying most of the time in Penang? Did you find this the best place to live?
• Did the smoke haze from the fires in Sumatra cause any great difficulty for your eyes? Or was it not as bad as it would seem (from a distance)?
• I realize the humidity would be great for your eyes, but did you find the heat to be a problem? Did you use A/C a lot or (heaven forbid) fans?

Thanks for any information
Neil

[Guest]

Humidity definitely makes my eyes feel a lot better.

[neilw]

SAAG,
thanks for answering my questions. I am sorry I have not replied sooner but I have been fairly busy the past couple of weeks and have not been on DEZ much. Penang certainly sounds it would be worth considering for us but I cannot see us getting the time to go over to explore this year. Hopefully we will be able to next year. Right now it is mid winter in Melbourne, very wet and so the weather is good for Kathy's eyes. It is the summer here that is the worst.
Neil