Milky ooze from upper puncta

[spmcc]

I had intracanalicular plugs placed in my upper puncta on Feb 1, 2010 (I already had intracanalicular plugs in the two lower punta).

Almost immediately, my left eye became very oozy... I've had dry eye for 15 years and never even produced normal "sleep" in my eyes. Now my left eye (especially) is gooey, mucus-y, and stuck shut in the morning. My vision is often blurred because of the gunk that accumulates.

Twice my left eye has been swabbed and cultured. One result came back negative. The other I haven't received yet.

I had all 4 intracanalicular plugs flushed on March 25. But my left eye is still very oozy.

Now I notice that the area around the left upper punctum is slightly swollen and, when I push gently on the punctal area, a milky ooze comes out.

I've tried erythromycin ointment, azasite, and (I take) oral minocycline 50mg.

Is there anything else I could try? I have a bad feeling this is a result of the intracanalicular plugs (duh, really!). And I don't know what else to do... if the culture doesn't come back positive, the doctors don't feel like it's anything!

Thanks.

[gz9gjg]

Hello spmcc,

I suggest you get this problem checked out by a doctor. It sounds to me as if you have an infection or maybe (though less likely) an allergic reaction.

Good luck . . .

[spmcc]

Re: update

So, I had my 4th visit to a doctor regarding this milky ooze from my upper punta. Then I was referred to another OD who believes it's probably canaliculitis... inflammation of the lacrimal canals due to the intracanalicular plugs that I had put in on Feb 1 and irrigated out on Mar 25!

This OD flushed me (again) with saline and antibiotics (yuck... goes down the back of your throat). He gave me some more antibiotic drops (vigamox), upped my doxycycline for 3 weeks, and sent me on my way.

I am now hoping I can return to my 'normal' dry eyes... didn't think I'd ever wish for that!!!

[sighthound]

I have plugs. Eagle brand. I was told by 2 eye drs that Smart Plugs are a bad idea. They can get stuck in the wrong place. They are impossible to for the dr to see, and therefore not clear if they are gone or not.

[spmcc]

The reason why I had intracanalicular plugs put in the lower puncta in the first place was because I have two different sized puncta due to cautery tried twice in the late 1990s. Because the puncta were different sizes, I had to buy two different pairs of silicone plugs just for the lower puncta.

I also didn't like that the cap of the plug rubbed my eyeball. My OD didn't like that either.

So, this time (back in Sept 2009), she decided to put in intracanalicular plugs (one size fits all) in the lower. I was fine with them (altho lower plugs never helped my eyes feel less dry).

It wasn't until Feb 2010 when we plugged the upper puncta (and she insisted on intracanalicular plugs) that I had any problems.

In 15 years of my dry eye, I had never had my eyes produce any goo EVER. Then, after the upper puncta were plugged, my eyes produced so much gunk (not tears) I just couldn't believe it.

Anyway, it's been 4 or 5 days after flushing and antibiotics and my eyes are back to plain ol' dry (yahoo???). But I'm especially happy the ooze is gone because I am heading to Palo Alto on Tues to have IPL with Dr. Neil Freidman. His info booklet that they sent via email says they won't do IPL on an eye with active infection... I worried about flying all the way there to be turned away! Now I think I'm okay to go ahead!