post-cautery question

[Lacrima]

Hi,

I have had one of my upper puncta cauterised. I notice when looking up close in the mirror, I can still see the dot of the puncta. I was hoping other people who have had cautery, might be able to tell me whether this is normal or not..

I was expecting the whole surface to become flat and no puncta to be visible...


Thank you

L.

[Guest]

My impression from my doc is that yes, it can be normal to see a dot there and does not necessarily mean the puncta is still open.

For me, my upper right has no dot visible and has always seemed to stay shut. My left upper has always had that dot and it's the one I suspect is still open since the longest it's ever stayed feeling shut is 5 weeks. Off to get the suture/cautery combo on that one next... but waiting for my referral to the plastics guy. Ha... I sound like I'm ordering a fast-food meal! Would I like to supersize that?

Also, I've always been a bit grossed out by the notion of what I might see up there, so I've never looked myself... this is based on what my doc has said HE can see.

[jenny2008]

i just read this and was asking the same thing! i had my upper left cauterized (its my worst eye and i have sjogrens & mgd) well before cautery my left eye was already giving me tons of trouble with an umbrella plug--so dry all the time and the plugs kept falling out... i had cautery done-it reopened witin 3 days-had it done again and was told it was normal for there to be a slit... i even had it tested by a specialist with some saline and i didnt taste it when they probed at it and put the saline in it..

anyway on my doc visit today i brought up how ext dry my left eye is all the time and he commented that on the surface it looked open but that didnt mean it was open on the inside.. very frustrating.he spent over 20 minutes with me but didnt want to probe at it.. he said when i come back in 5 weeks he will do so then if im still feeling its open... i think he is being cautious since he didnt do the cautery and i just started going to him in dec..

Lacrima when did you have cautery done? is your eye still dry?

[No tears in ATL]

Interesting. I had my upper left cauterized about a week and a half ago and was wondering the same thing. I can see my puncta as well. Next week I go for follow up eval, so maybe they will be able to tell. Best of luck. Do you have a follow up scheduled? Please let us know what the doc says.

[jenny2008]

ok well maybe mine is still shut then.. its prob just my left eye is so dang dry all the time anyway.... it felt like this with a plug for about 2 months before i had cautery=so it may just be dryness and inflammation due to my sjogrens ...

i was told by 4 docs -2 corneal specialists and 2 reg opthamologists that cautery often heals with you being able to still see the outside of the puncta... but then they still dont know for sure if its closed allthe way thru..frustrating... i know they can check it again with probing and a saline solution but the probing hurts....\\

no tears--please let me know what your doc says about the cautery... how do you feel ? does it feel closed?

[No tears in ATL]

Hey Jenny. Honestly, it's hard for me to tell that much of a difference right now. My left one is my problem eye or at least it has been lately. Other issue is I have six month dissolvable ones on the bottom, and it seems like those have mostly dissolved. So I guess I won't fully know if cautery has helped until I get ALL four done. I think that is in the works with my new cornea specialist I see next week for follow up. Hope yours gets better!

[Lacrima]

Hi Jenny,

I've written you a pm, also. I had it done just under a month ago. The improvement i've had is a bit more general comfort in normal conditions- but as soon as I'm exposed to hot weather, wind, air conditioning etc my cauterised eye is just as bad as before.

Prior getting cauterised I was trying out an upper plug and I remember having more moisture than now. (Although this could very likely be due to the very hot,dry summer climate i'm in at the moment)

I might also request to get it done again at my next appointment in 1-2 months.. Maybe that's the only way to tell for sure?

Good luck with your next appointment- pls come back to say how it went.

[Lacrima]

No Tears in ATL thank you, good luck next week at your evaluation. I will come back and post what happened after my next appointment.

[Lacrima]

I sound like I'm ordering a fast-food meal! Would I like to supersize that?

I would like to order some fried puncta- please cook them well so I never see them again!

That's interesting about both of your eyes healing differently- I guess wherever there is a dot, there will always be a doubt..

Thank you for the helpful info- that a visible puncta does not always mean it's not closed.

[jenny2008]

No tears and Lacrima--- do you both also do the warm compress and massage for your glands?? i do--i would not think that would cause cautery to reopen... ???? my doc said to continue to do it after cautery but to wait 3 days....

i am not scheduled to go back to my doc until early aug-but may go later this week if i can get in. not sure.. not sure if he would do the cautery as he isnt the doc who originally did it and he says i have a good tear lake-even tho my eye feels so dry and awful!!!! i have the weird foreign body sensation.... can you relate?

[Lacrima]

Hi Jenny,

I do heat treatment and massage every day, morning and night. After the cautery my doc didn't mention anything about stopping but I took a couple of days' break until the swelling had gone down. (The anaesthetic caused a lot of swelling).

It is also my left eye which is worse- the right has only the bottom puncta plugged. The left has bottom plugged and upper cauterised.
I don't have this foreign body sensation in my eyes that you are talking about- is it on your whole eye surface?Do you feel relief with eyedrops?

I just feel a strong stinging like when cutting onions- and they feel really raw,chalky and exposed when I am in the wind. Air conditioned spaces are the worst for this..

I'm managing ok with (a lot of) eyedrops, so for the time being I think I can hold out til my next appointment in 1-2 months.

I'm going to see if my opthalmologist will causterise it again for me, if she's also not sure it closed properly..

Good luck, pls write how you get along.

L.

[jenny2008]

L. thanks.. i have always gotten the foreign body sensation when super dry---maybe it parts of my autoimmune disorder? not sure..
anyway i am gong to my doc on thurs so he will take another look.. When is you next apt? i will keep you posted...

[No tears in ATL]

Hey, Jenny. I don't do the compresses, since I (cross fingers) do not have any MGD issues right now, just the aqueous deficiency. Tried it but all it did was make my eyes red. The only foreign body sensation I had was when I first had the cautery done as it was healing. When I would look far to the right or left the new scar tissue would rub a bit, but all is fine now. I would say it took about 5 days ago for that feeling to go completely away.

[Lacrima]

Hi,

I had said that I would return with an update after my next check up. Apparently the puncta is closed, it just looks open. I notice that when I put restasis in the eye which is plugged and cauterised, I don't taste the restasis going down my throat, but sometimes I do from the non cauterised eye. So for now, I will leave things as they are!