Too Many Tears - What Can I Do?

[Tankie]

Hi everyone,

Some of you will probably envy this, but I just got upper punctal plugs put in (I already had lower plugs in) and now I have too many tears! It feels great on the eyes, but it's very noticeable to both myself and to other people that I have tears in my eyes at all times. Any ideas as to what I can do about this?

In a perfect world, I would have just enough tears that it prevents my eyes from hurting, while at the same time not too many so I avoid essentially having a reservoir of water running along my lower eyelids.

Dabbing them with a tissue periodically is the best solution I have so far, but even with that the tears come back quite rapidly, and I can't go around dabbing my eyes with a tissue every 2 minutes. If I don't do this, however, eventually tears stream down my face.

This is kind of funny. I'm not in pain, but I can't stop "crying" now lol. This might be the cure for me, after all these years, we'll just have to wait and see, but I've definitely got to find a way to stop "crying".

[Dog2012]

Hey Tankie,

How is your new drops ..we are here waiting to hear it
?

Hi everyone,

Some of you will probably envy this, but I just got upper punctal plugs put in (I already had lower plugs in) and now I have too many tears! It feels great on the eyes, but it's very noticeable to both myself and to other people that I have tears in my eyes at all times. Any ideas as to what I can do about this?

In a perfect world, I would have just enough tears that it prevents my eyes from hurting, while at the same time not too many so I avoid essentially having a reservoir of water running along my lower eyelids.

Dabbing them with a tissue periodically is the best solution I have so far, but even with that the tears come back quite rapidly, and I can't go around dabbing my eyes with a tissue every 2 minutes. If I don't do this, however, eventually tears stream down my face.

This is kind of funny. I'm not in pain, but I can't stop "crying" now lol. This might be the cure for me, after all these years, we'll just have to wait and see, but I've definitely got to find a way to stop "crying".

[Tankie]

It is a bit early to tell, but I didn't feel that they did anything that most other lubricating drops do. However, they are preservative free, so that's always a plus. I wouldn't recommend others to rush out to buy them, but if you think they could help you they should do you no harm to try.

With that said, having 4 plugs in my eyes has really taken away my pain. The problem is that there's tears in my eyes at all times and they over-flow. Not sure if this will change with time, which is why I'm trying to see if anyone out there has a suggestion.

[DCRdryeye]

Hey Tankie, if you read my thread http://www.blockedtearductsurgeryadult.com it will explain how I had to (or bullied into rather) having surgery for a watery eye. I never had dry eyes prior and only the left eye was leaking at the extent of having to wipe it with a tissue twice a minute. It's all in my website...have a read.

Anyway, it's good you don't have pain. I know you have MGD because you've spoken about it, but salty tears on an ocular surface without lipids to protect it? (or I could be wrong perhaps the meibum is the 'top' of the aquous layer and mucin directly on ocular surface). I've had times with my dry eyes where they've teared and it really hurt and made my eyes red.
In terms of what you can do about it. I know there is a plug that Eagles make that have a small hole through the middle to allow some tears through. Perhaps look into them? By the way, what type of plugs do you have? Are they comfortable?

Persist for now, I wouldn't go removing the uppers, you've only just got them. Let the system balance itself out for awhile. See what happens in say, 3 weeks from now. (I put up with a leaky eye for 2 years). You can put vaseline around your eyes to "catch" the tears and prevent too much from rolling down your face. I know people may think your crying, but the same goes with applying artificial tears. I was at a huge mind/body festival in a major city a few years ago and they had air conditioners going. I didn't want to walk around with dark moisture chambers so kept applying artificial tears. Anyway, I had just applied (for the 10th time) more artificial tears, and they started rolling down my face. A lady at an astrology stand got really concerned and came close to me in an attempt to comfort, and said, "Oh - you aren't crying are you" and she wanted to help LOL. I took my artificial tears out and showed her I have dry eyes and have to use them. Isn't it the weirdest thing when you assume something you think is so right, but turns out to be completely wrong.
Tankie, after all this time, going through expense with Lipiflow, etc, why now? Why now chose the most common treatment recommended by ophthalmologists?. If you have severe dry eyes and lower puncta's aren't working for you...it's obvious to try the uppers. I'm curious, why now?

By the way, you know debris etc may accumulate on the occular surface with plugs causing inflammation, so twice a day give them a good rince out with saline

I'd also not give up on treating MGD, if the plugs are helping the ATD, you still have MGD to deal with.
Keep us posted, and I'm really thrilled you have some relief From desert to a monsoon...what a ride!!

[robster]

Tankie some Optoms now offer flow controller plugs - www.dryeye.org/flow.htm. I haven't tried them myself but it might be worth looking into. I had massive tear overflow when I had upper plugs on top of my lower ones and eventually had to have the uppers taken out so I know what your going through!

[Tankie]

DCR, you are absolutely right! I've suffered with dry eyes for 5 years and the last 1.5 years of suffering could have been avoided if I had just plugged both the top and the bottom. Why now? Because 1.5 years ago the doctor told me not to block both because of the overflow issue. I finally decided to do it, and now I'm pain free! This is a huge huge deal to me and I can't believe this day has finally come... and I can't believe it came so simply. It's a little bit embarrassing, given all the money I've spent and all the knowledge I've acquired about other treatments, but in my defence, it was because of a doctor who told me not to block both that I never did it until now.

Yes I have MGD. There is absolutely no doubt about it. However, it would appear that I can get by on my watery tears. The only problems I now face are cosmetic (i.e. looking like I'm about to cry) and perhaps a small amount of blurriness when I'm about to overflow.

It truly is unbelievable that after all this time, that THIS would be my cure. Unreal... I feel so happy, and so silly at the same time. But how can I blame myself for trusting a doctor's advice. O well, I won't point the blame at anyone.

I could sit back and be angry. I could sit back and think about all the years I wasted. But instead, I choose to have a positive outlook. I feel very blessed and lucky to be pain free now and I've developed a lot of character and perseverance through all this pain, and I'm going to put my efforts towards good things.

I'll still be around on the forums just in case this turns out to be a false alarm, but I honestly believe I've reached the end of my journey now.

Plugs with a small hole in them sound like a great way to regulate the tears in my eyes. I'll have to look into it in the future. I'll definitely "tough it out" with the current plugs I have for now though (although frankly this is very very very very!!! easy compared to what I have been through in the past).

[Blinks]

Tankie, Congratulations on having tears again!
Are the plugs the temporary trial dissolvable ones, by any chance?
How long have the plugs been in place? Is it possible the tear flow many equalize a bit after a few weeks? Lots of questions, and you've had some good research on this.
The doctor started me with four plugs of the temporary type. Then after a few weeks inserted the "permanent" ones. The uppers fell out after awhile, but I didn't have them re-inserted. The lowers do just fine. Ten years later, they fell out (or were removed) after surgery but were re-inserted in February and so far, they've been fine.
Just thinking the adjustment may take a bit of time to settle.
Cheering you on for sharing your artificial tears experiment! And a big vote of thanks for your post on sourcing non-buffered saline, too.

Best wishes,
Blinks

[farmgirl]

Hi Tankie:

I am so happy for you that you now feel good enough to believe that you are at the end of your journey. I like the idea of the plugs with the hole, sound like it might just fine tune what you already have. I found the same thing, immediate relief when I got all 4 plugged. No overflow tears for me and right now I have a temporary on the right because the silicone one kept coming out. It leaks a bit I know because it doesn't work like the silicone one and that eye is not as comfortable. At times I can taste the restasis in the back of my throat. I am out of the country right now for that cold Canadian winter but when I get back in May I am going to have a custom silicone ordered for that side that will hopefully stay in and I like you will be totally comfortable. I have to admit on the odd occasion that I actually overteared I didn't like it because my vision went blurry.

I fail to understand why so many Dr.s are reluctant to recommend plugs. For crying out loud if they don't work they can be removed it's not like they are being cauterized right off the bat. I have my uppers cauterized and the Dr has offered to do the lowers but I won't do it because if I every recover function (I have Sjogren's and am looking to cure it) I will be in the same boat as you. I'm sorry that you had to suffer so long because you trusted a Dr.'s bad advice. I hope you have made him aware how wrong he was to discourage you. Good luck with the fine tuning and I hope that others who are afraid to try plugs take the plunge and insist on at least a trial....cheers...F/G

[Tankie]

Thank you both for your kind words!

Blink: I've only had them in for 2 days, but I know this is the end. I feel absolutely perfect today as well. I'm overflowing with tears, but there isn't any pain. I promise I will keep updating just in case I am sounding a false alarm in claiming that I'm cured, but I am quite certain of it. Under normal circumstances I exercise restraint and caution before claiming something works, but this time around I am certain of it and I feel safe to post the news immediately. Again, I will not disappear, I will keep everyone updated to prove that I'm still cured.

They are permanent plugs in both the lowers and uppers by the way Blink.

Unfortunately for me my bank account is very low at this point (actually it's in the negative money) and I'm going to need to save up for a bit before I can try removing these plugs and putting in the ones with holes in them. However, I'm starting a new job in the new year so I should have enough money soon.

Yea farmgirl, you're absolutely right that doctors should not be reluctant in putting plugs in, after all, it's not cautery (i.e. it doesn't have to be permanent). The sage advice (*sarcasm*) I was given is that only 10% of your tears drain from the uppers, so there's no point blocking them. 10% huh? I don't know what the number is, but I can tell you it is a lot more than 10%. But regardless, there's no point in being sour about it. I'm just so grateful that the pain is gone. I realize full well just how lucky I am, because there was a point in time where I was wondering if I would have to go on disability and never amount to anything in my life. Just lying on a bed or sitting on a couch with my eyes closed listening to a TV, getting up only for meals and to use the washroom, and thinking about the world spinning by leaving me completely behind. Now, I have a second chance, and I intend to use it.

[Hemu]

Tankie, I am extremely happy for you and I hope this ends up being the permanent recovery for you.

Other than over-tearing, I've heard that plugs tend to have excessive bacteria accumulate around them and thus, it's preferable to only plug one of the two ducts for an eye. Some drainage needs to occur and thus, they usually plug the lowers. However, in those cases, I'd like to think the patient would feel some itching or something which you clearly are not so great!

There are others too on this forum Ive ran into who have all 4 ducts either plugged or cauterized.

[Lucy]

Tankie, hello!
I did not read through the whole thread above, but got the idea of your post. I'd agree to NOT have the uppers removed, at least no time soon. Your eyes can go dry again any time. The winter weather could do it, depending on where you live. Any number of things can do it and we don't always know. A long time ago, I had epiphora in one of my eyes. I was working still then and I had to explain to everyone that I was not crying. It seemed so lame at the time, but I'd had multiple plugs in and they always seemed to fall out. It's probably preferable to have the lowers plugged if you are going to plug one. I do believe all 4 plugs may be a bit too much sometimes. Like I said, thou ugh, for me I do not know what happened or when, but the over-tearing did not last forever. I currently have 1 plug, 1 cauterized and both lowers scarred shut from so many plugs, unplugging etc. Congrats on the tears and I hope they even out. Lucfu

[Dog2012]

Dear Tankie,
I am also very hippy for you !!! We will miss you here :}
I remember in the past you said that you also have low lids retraction ..Did you fix that one problem ?

Thank you both for your kind words!

Blink: I've only had them in for 2 days, but I know this is the end. I feel absolutely perfect today as well. I'm overflowing with tears, but there isn't any pain. I promise I will keep updating just in case I am sounding a false alarm in claiming that I'm cured, but I am quite certain of it. Under normal circumstances I exercise restraint and caution before claiming something works, but this time around I am certain of it and I feel safe to post the news immediately. Again, I will not disappear, I will keep everyone updated to prove that I'm still cured.

They are permanent plugs in both the lowers and uppers by the way Blink.

Unfortunately for me my bank account is very low at this point (actually it's in the negative money) and I'm going to need to save up for a bit before I can try removing these plugs and putting in the ones with holes in them. However, I'm starting a new job in the new year so I should have enough money soon.

Yea farmgirl, you're absolutely right that doctors should not be reluctant in putting plugs in, after all, it's not cautery (i.e. it doesn't have to be permanent). The sage advice (*sarcasm*) I was given is that only 10% of your tears drain from the uppers, so there's no point blocking them. 10% huh? I don't know what the number is, but I can tell you it is a lot more than 10%. But regardless, there's no point in being sour about it. I'm just so grateful that the pain is gone. I realize full well just how lucky I am, because there was a point in time where I was wondering if I would have to go on disability and never amount to anything in my life. Just lying on a bed or sitting on a couch with my eyes closed listening to a TV, getting up only for meals and to use the washroom, and thinking about the world spinning by leaving me completely behind. Now, I have a second chance, and I intend to use it.

[Tankie]

I agree Lucy. I sure hope the tearing never stops. It might be a bit of a nuisance, but I would keep my current state forever if it meant I would never have to go back to how things were in the past.

Yes Dog2012. My lagophthalmos is very near perfectly fixed. I had a lower lid retraction with a sclera graft, and I also had a tarsal strip done on each eye. Will it last forever? Maybe not. But for the time being my eyes close completely, or at least extremely close to it. The last time a doctor took a look, he said the left closes 100% and he saw a 1 millimetre opening on the right.

[jax8it]

Tankie,
I am so glad you have found something that works! Please post back and let us know how things are going.
I have read a lot of your posts and you give such wise advice for someone so young.
Bianca

[Katewest]

I hate to be a Debby downer but here is my experience with 4 plugs. The first night I was as excited as tankie is. I was even thinking about all the makeup I can wear again! That's how hopeful I was. The next day I went to work, where my eyes are always worse, and they felt just as dry! Ok, so using the computer they didn't hurt as much and I could be on longer. However, when I was walking around and the air hit them it was the same dry eye pain. I also had annoying overflow that really bugged me. I think 4 didnt work because my mgs are still blocked and the tear film has no oil. I took them out three days later. I had some rebound redness for a week then they went " back to normal. Now, I did NOT give them the 2 to 3 weeks to normalize like my doc said. Bottom line, I do think we should advocate, research, and push for treatments. My doc doesn't think my eyes are " that bad" either, but I am looking for a career change because of them! He is against scleral lenses and serum drops, which I am pursing anyway.