Punctal plugs and nasal passage discomfort

[Súil Eile]

Hi everyone!

I haven't been on here in a while, as my opthamologist strongly recommended that I stay away from computers as much as possible...but I couldn't resist the lure of this forum for long

I got punctal plugs ("smart" plugs) put into both eyes back in November. The difference has been significant...particularly when driving at night. I hadn't realised how poor my vision was whilst driving before: I must have been a menace on the road for years! I'm now using between half and two-thirds the amount of eye drops I was before and my comfort level has increased drastically.

My main issue now is that since I got the plugs put in, I've had a constant sniffle. I need to blow my nose on a very regular basis, I sneeze a lot, and I feel nasally in general. Has anyone else found this after getting plugs and has anyone found a way to deal with it?

Any advice/ thoughts would be greatly appreciated!

[Guest]

This is not based on anything I've read... this is just my own little personal theory... I noticed that my sinuses/nasal passages got drier after having all 4 puncta blocked off (plugs/cautery)... wondering if the tears that used to drain into my nose helped keep the sinuses/nasal passages more moist? Then we block those tears from getting in there and it gets drier?? Then, I suspect this dryness contributes to a stuffy feeling... maybe sneezing too?

Anyhow, the following products have helped me with this (sneezing, stuffiness and dryness of the nose):

NeilMed's aerosol nasal mist (it's preservative free, I believe)... the best saline nasal spray I've tried... I LOVE it!!

For super dry days, I like to give my nose a rinse with the NeilMed Neti Pot... keeps it feeling more moist/less stuffy/less sneezing for hours.

[Súil Eile]

Thanks SAAG!

I bought a bottle of Sterimar nasal spray today (the NeilMed stuff is very expensive here) and even after the first use I felt some relief. I've used it twice today and my nose/ sinuses no longer feel as dry and uncomfortable.

I absolutely agree with your theory. My nasal passage must have been luxuriating in the bath of eye drops it was getting every day! Now that there is no fluid getting into my nose and sinuses, things have understandably dried up. I'm going to mention it to my eye doc at my next appointment - it really is a side affect that patients should be told about prior to getting plugs inserted so they are aware of the symptoms and treatments.

[Guest]

I bought a bottle of Sterimar nasal spray today (the NeilMed stuff is very expensive here) and even after the first use I felt some relief. I've used it twice today and my nose/ sinuses no longer feel as dry and uncomfortable.

Great to hear! Glad it's helping!

[y-gwair]

Yes, I've had this problem as well since being plugged.

[Súil Eile]

Hi y-gwair,

Have you come up with a good solution to this problem?

[Rebecca Petris]

I think that partial occlusion plugs could address this in some cases. Obviously not appropriate for someone who absolutely has to have total occlusion in all four ducts, but perhaps helpful for others.

I'm trying to remember if some of the newer dissolvable plugs also act as partial-to-mostly occluders or not... indrep any thoughts?

[indrep]

There are Flow Control plugs available for partial occlusion. I am unaware of any studies that discuss nasal issues in relationship to punctal occlusion. I always assumed the nasal passages were coated with mucus. Now I'm thinking the same systemic issues that cause dry eyes could also being decreasing mucus secretions. Also I will research and see if the trigeminal nerve loops include the nasal passages.

[Súil Eile]

I must ask my eye doc next time I'm back. The option of flow control plugs wasn't explored, although I probably would have opted for full plugs anyway as I'd be more concerned with keeping moisture in my eyes than my nose.

[Margaret]

just a bit-o-info to the thoughts here

I had Lasik 9 months ago and around month three had such pain on one side
(right side) of my sinus/forehead/eye that it took me to the emergency room. The doc there thought it was trigeminal nerve pain and was hoping that it was only acute and that after the nerves grew back I wouldn't feel it again. After that bout, I also had sinus dryness on the right side. I'm happy to report I've had pain in my right eye, but it has never been the same intensity. I've also noticed after months and months of feeling dryness in the right nasal side that I don't feel the cold dryness I used to AND I even added permanent plugs to the mix which should have made it worse. So, I'm more tempted to believe it's related more to the nerve growth than the plugs drying things out, but I'm sure the additional tears in your eyes that we all used to have probably helped things out. When i was at my worst with the nasal dryness/pain, I actually used the thicker night time eye drops and would put them in my nose! It helped a lot at night...

[Súil Eile]

When i was at my worst with the nasal dryness/pain, I actually used the thicker night time eye drops and would put them in my nose! It helped a lot at night...

Ha ha...I just had an image of me trying to get eye drops up my nose! How did you manage it?

Since I've started using the nasal spray my nose hasn't been quite as dry. It still feels very blocked though, particularly first thing in the morning. But it's definitely more comfortable than it was last week.

Margaret, I had nerve pain in my arm and shoulder due to a slipped disc a couple of years ago. I have to admit it was the worst pain I've ever experienced. I can't imagine what it must be like for you to have that kind of pain in your eye! It sounds terrible.

[indrep]

There are nasal sprays that include sodium hyaluronate (hyaluronan, etc.). This moelcule is a mucopolysaccharide that is very simialr to the mucin layer of your tear film and mucous lining of nasal passages. The molecule holds 1000 times its weight in water and bonds with epithelial cells to insure long residence time.

[Súil Eile]

There are nasal sprays that include sodium hyaluronate (hyaluronan, etc.). This moelcule is a mucopolysaccharide that is very simialr to the mucin layer of your tear film and mucous lining of nasal passages. The molecule holds 1000 times its weight in water and bonds with epithelial cells to insure long residence time.

I'm going to look out for one of these to use in conjunction with the Sterimar spray. Thanks Indrep. What would we do without all your expertise? It's great to have someone with so much knowledge around, thanks a million

[Súil Eile]

I'm just curious as to whether anyone has tried an oil to alleviate nasal dryness? I've come across a brand called Nozoil through google and I'm wondering if anyone has tried anything similar? No pharmacies here seem to carry OTC remedies for nasal dryness. A helpful pharmacist today said that after nasal surgery a few months ago he was prescribed an oil to lubricate his nasal passages. Unfortuntately he couldn't remember the name!

[Guest]

I'm just curious as to whether anyone has tried an oil to alleviate nasal dryness?

Especially in winter when the air is soooo dry, I use a q-tip to apply a thin layer of vaseline (petroleum jelly) inside my nose every night before bedtime. It helps enormously... no more nosebleeds.

(I know it's not an oil really... but kind of similar because the vaseline is so greasy)