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i read on here that the doc can use a dye to test if the cautery has reopened? can someone explain that? also i understand saline can be used but then i read that can cause the puncta to reopen??
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Jenny -
You are asking the question in a patient only forum, if you were to ask an eye care professional in the Pro talk section, you will probabaly get an answer.
Unfortunately I have noticed this pattern, were the public ask in the patient only forum, and end up getting answers which maybe inaccurate or only half right etc, unfortunately eye care professionals are not supposed to post in patient only forums, so cant help you.
regards,
Ahmed. -
Jenny,
The doctor can put a drop of lissamine green or other dye in the eye and theoretically see if it drains through the puncta. A better test is to close off the nonplugged puncta and push on the lacrimal sac and see if fluid comes out of the suspected puncta.Comment
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RE: how to tell if puncta are open after cautery
I think it's a guess on the doctor's part.
I've had doctors say they can (1) see the opening and tell if it's open/closed, (2) use dye to test if it's taken up through the punctum during blinking, (3) use regurgitation of tears through the canal to see if it's open/closed, (4) inject saline (altho that can open the punctum if it's just hanging on), and (5) insert plugs (altho again, can force the punctum open).
Please don't hold me to any of the above... it's just what I've heard from many different doctors over many cauteries over many years.
As for what I believe... I can tell when my cauteries open. My eyes get very dry. It could be 24 hours after cautery or 2 months after. But I know when they open. Then I go for another cautery and they become more comfortable again.Comment
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thank you both so much. Indrep, What do you mean by closing off the nonplugged puncta though? the puncta that has been cauterized and just pushing on it??JennyComment
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Also... does a cauterized tear duct still have the tiny slit that you can see? I can see where there is an opening but it doesnt look hollow like the open puncta in my right eye? what should a cauterized tear duct look like?JennyComment
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spmcc-have you looked at your puncta after cautery? can you still see an opening? or i guess what i am asking is can you tell by looking when they open back up? thanks!!!JennyComment
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Yes, I've looked at my punctum and I sometimes I see the little black dot. But that doesn't necessarily mean it's open (at least that's what I've been told). That's why I don't think they can just look through the slit lamp and tell.Originally posted by jenny2008 View Post
And that's why I go by how my eyes *feel*.
I believe what indrep is talking about is what I mentioned above: regurgitation. What the doctor does is pushes firmly at the base of the canaliculus (i.e., not at the opening). Then he/she waits a bit for tears to accumulate. Then he/she slides his/her fingers up towards the opening (the punctum). If tears have accumulated in the canal while he/she was applying pressure and he/she can push tears up and out of the punctum, then it's open. In other words, there's regurgitation of tears through the punctum.
Bleh! I hope that makes sense despite all the he/shes and his/hers!!!!!Comment
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jenny,
If only the lower puncta is occluded the doctor would use his finger to close the upper puncta so that when he pushed on the lacrimal sac the only opening would be the lower puncta. If it was open there would be an expression of fluid back into the eye.
As for how it would look it would depend on how it was cauterized. If it was surfaced cauterized, probably the least successful, it would be visible. Deep cauterization would not be visible to the eye.Comment
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i know the first time i had it cauterized it was just the surface and it reopened within a few days. I went back 2 weeks later and had it done again and the doc numbed be with several more shots and the procedure took about 5x as long ... Having cautery cannot make the eye itself drier can it? Is that a potential side effect? thanks for all the responses. i really appreciate it...JennyComment
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Jenny,
It shouldn't make it drier unless the surface cautery caused a malformed lid margin and the lids to not close completely.Comment
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