Smart Plug removal, still have excessive tears

[jsalad]

It's been a while since I've been on this board...I had all 4 ducts plugged with Smart Plugs (the ones that are in the canal, no cap on outside.) My dry eye has improved significantly and have been happy with the results.

About a year ago, I started having excessive tears in my right eye. So much tearing, that it would run down my face all day long. Some days are better than others...same as when the eyes were excessively dry. I've been to 2 doctors to remove the lower plug...and both times irrigated and felt the saline going down my throat. This led me to believe the plug was gone. But I've still had excessive tears in that eye for a year. I recently moved to another state, and finally decided to try a new doc to irrigate again. He irrigated this morning, and really washed it out for a few minutes. I asked him to do the top as well, but he said we didnt need to....that as he was irrigating the bottom, saline was coming around and out of the top duct? It's now late afternoon, and I'm starting to tear up again.

I'm wondering if anyone else has had this problem after being irrigated and believed to have removed the plug? Doc says the only thing left is surgery to basically create an additional tear duct...which just doesnt sound like a good idea.

[DCRdryeye]

Hi jsalad. The surgery the eye doc is referring too is DCR. He's assuming you have a blocked tear duct in the naso-lacrimal duct. If you can feel the saline in your throat during the syringing then you may only have a partial blockage. I can't think of any other reason for the tearing to persist. It's a bit worrying that the saline was coming out of the top puncta....that's usually a sign of a blockage in the naso-lacrimal duct.

An oculoplastic surgeon told me that having all four punctas blocked will dry the naso-lacrimal ducts and cause them to narrow in some cases. Perhaps this has happened to you?

In terms of the DCR, I wouldn't go ahead with it. I know the tearing is very annoying and you want relief, as I did. But knowing what I know now, DCR is not the only option for excessive tearing. I'm currently putting an extensive blog together about DCR surgery and the non-invastive alternatives "they never tell you about" and will let you know when it's ready (should be next week).

[jsalad]

Thank you DCRdryeye! I did some research yesterday on DCR and there's no way I'm interested in doing that. At this point, I would rather live with tears running down my face. The more I read on this site, the more I'm thankful I am that I only have the tearing issue, and not infection from this plug.

I think you are correct, that I either have a partial blockage or possibly the ducts have narrowed from dryness. Both of these make sense.

I look forward to reading your blog about the alternatives to DCR! I'd like to get some relief, but not by an extensive surgery such as DCR. Thanks for giving me a heads up when it's posted!

[bbga]

I'm in the process of finding a surgeon to remove my smart plugs due to infection and I keep running into surgeons that want to go straight for a DCR. I went home and did research when I first heard of it too and there is NO WAY am I doing that either.

[bbga]

Hi jsalad. The surgery the eye doc is referring too is DCR. He's assuming you have a blocked tear duct in the naso-lacrimal duct. If you can feel the saline in your throat during the syringing then you may only have a partial blockage. I can't think of any other reason for the tearing to persist. It's a bit worrying that the saline was coming out of the top puncta....that's usually a sign of a blockage in the naso-lacrimal duct.

An oculoplastic surgeon told me that having all four punctas blocked will dry the naso-lacrimal ducts and cause them to narrow in some cases. Perhaps this has happened to you?

In terms of the DCR, I wouldn't go ahead with it. I know the tearing is very annoying and you want relief, as I did. But knowing what I know now, DCR is not the only option for excessive tearing. I'm currently putting an extensive blog together about DCR surgery and the non-invastive alternatives "they never tell you about" and will let you know when it's ready (should be next week).

Hi DCRdryeye. I would definitely like to read your blog when it's ready too. I'm in the process of finding a surgeon to remove my smart plugs due to infection and I keep running into surgeons that want to go straight for a DCR. Like jsalad, I went home and did research on it and there is NO WAY am I doing that. If there is a way to let me know when your blog is posted I would really appreciate that.

[DCRdryeye]

Hi bbga, my website/blog is now ready and online please go to: http://www.blockedtearductsurgeryadult.com/

[bbga]

Hi bbga, my website/blog is now ready and online please go to: http://www.blockedtearductsurgeryadult.com/

AWESOME, thank you.

[jsalad]

Thank you DCRdryeye for the link. Your story is heart-breaking, but your willingness to share it with the world will help many in the future. I hope that brings some comfort to you. Your blog is much appreciated. Take care.