Plugs vs. Cautery: A Story

[rubyslippers]

I had the lowers plugged in mid-April. Cannot feel a thing and it helped a lot. Last week I had the upper plugged on the worst eye. It also made a big difference. I don't have any of the over tearing. My next step is to probably have cautery on the lowers and a permanent in the upper. I am more concerned about the permanent plug than I am about the cautery. My doctor sees much less annoyance with the cautery than the plugs in patients but he does not believe in cautery for both in one eye because it is completely irreversible most of the time and if there ever was a cure (like Androgen drops on the horizon) he would want me to be able to take advantage of the cure.

[rubyslippers]

Update: I had plugs put in both lowers 2 days ago. They are the kind with a tiny top that shows at the top. Instant, and I mean instant improvement in both eyes. As the afternoon wore on one started to rub and I went right back and he pushed it down in lower and it has been fine but a bit irritated. He says if I show no allergic reaction for week, he will push them both a tiny bit lower making it less likely to lose them. If for any reason these do not work, I will be having my lowers cauterized. I have no overtearing whatsoever. I have a temp in one upper and if I do well with the lowers I will have that upper with a permanent one too. It is the dryer of the 2 eyes.

[lfs]

cautery not effective?

Does anyone have experience with cautery not being effective? I have lower plugs in both puncta and had both uppers plugged as well, but the right eye plug kept coming out. Plugging seemed to work well for me, so my dr. suggested cautery for the right puncta, which I did about 4 weeks ago. Surprisingly, though, my eye now seems to feel worse and she can't really explain why. I was back to see her and the hole is definitely plugged. But my eye is red, burning, feeling dryer than when plugged. Also, several nights a week when sleeping, I wake up with eye pain and a very teary right eye. Does it take a while for the body to adjust? I am really disappointed.

At this last visit, she checked my tear glands and noted that about half were atrophied and not producing oil. She recommended flax seed oil (1 tablespoon a day). Also, a regimen of warm compresses and upper/lower lid massage to stimulate oil production -- which I am loathe to do.

Thoughts anyone?

[hkgcomet]

Any reverse cautery experience?

Those are permanent, except if big problem occur and need to go to hospital to drill it open...

I feel the saltpool effect of fully plugged eye making it more sensitive...Hope one day I could remove a upper plug to see if it true.

[krose1000]

Plugs & Cautery

Hello Everyone!
I'm new to this forum and am so delighted to have found you. I suddenly developed "Dry eye" in 12/08. Been treating for over a year with usual Restasis, eye drops, steroids, plugs in lower eyes, etc. Nothing has allowed me to returned to wearing my contacts.
Finally got in to see Dr. Gary Holland @ UCLA and he told me I was misdiagnosed by 2 doctors. He said my dry eye was not just menopause, but posterior blepharitis. Now doing warm compresses, he expressed glands. Sent me back to my regular ophthamologist with recommendation for upper lid cautery and antibiotic drops, Flaxseed oil & omega 3's (which I already take), and nightly eye scrub. He said just clearing up blepharitis would give great relief.
I have improved significantly with the compresses (2x day for about 15-20 minutes). Azasite drops for 14 days have helped immensely. No
burning, stinging, shooting pain in all day! After 2 days of compresses, the horrible waking up with lid stuck to eyeballs stopped! So I was getting hopefull.
Had upper lid cautery 2 weeks ago and CANNOT stop constant tear flow.
Can't see to read, type, and driving is difficult with constant rain of tears.
So Dr. said it's a good sign and he will pull lower eye plugs out on Monday.
He saw significant less irritation just after the first expression by specialist, scrub, & compresses.
Made appointment with contact specialist for 3/22 based on UCLA contact specialist telling me to switch from soft extended wear contacts to hard or gas permeable lens, if at all. Said it is much healthier for dry eye because less irritation due to small size lens. I SURE HOPE SO.
WILL REPORT BACK ASAP. WISH ME LUCK
THANKS
KRIS