Too Many Tears - What Can I Do?

[patientpatrick]

WOW!!! this is amazing news. I'm completely envious but to be honest I'm amazingly happy for you. This is the best news I've heard in a very long time and has given me a lot of hope. I scheduled an appointment with a Dry Eye specialist the day after xmas and will be sharing this story with him. What type of plugs are you using? is there a brand name or style of plug? It would be great to have that info when I see him in a few days. Thank you so much for sharing.

Patrick

[Tankie]

I hear what you're saying Kate. I'll keep you posted, but I am pretty sure this is the real deal for me.

Patrick, I believe they were made of silicone. Unfortunately I didn't catch the brand name but here are a few tips:

1. Your doctor should already know this, but the largest size plugs that fit your tear ducts should be used.

2. I cannot stress the importance of this enough. Before you leave, ask for a mirror, or walk up to a mirror, or bring a mirror with you, and look at your tear ducts. If the lower plugs are the ones getting plugged, if you look where the little black dot usually is (this is your tear duct), you should be able to see a white plug there. If your upper plugs are getting plugged, use one finger to pull back your lid slightly and look where the black dot usually is; you should be able to see a white plug there. Make sure you know what the black dot looks like before you go, so you can notice the white dot instead once the plug is put in.

If you see any colour besides white, it means the plug is not properly in place. For example, if you see black, either the plug literally just fell out (and believe me this happens to a lot of people, including me before) or you can see the plug itself. The doctor should take about 2-3 minutes installing each plug (4-6 min total time for two). If he doesn't, he's being careless, and you need to tell him the check, and double check, and give it another push, to make sure it's securely in place. He should also look at the plug through a magnifier (through the thing your rest your chin on), otherwise he can't be certain it's in place. Make sure he does his due diligence, because the last thing you want is for those plugs to fall out.

I might have over paid, but my plugs cost $125 per plug, so $250. Then I had to pay my local taxes, so cost me $280.

Funny story (or sad story): I think I once remember reading about how much it costs to make a silicone plug, and the answer is some very small amount, such as a few pennies, or maybe it was $1 or $2. Either way, these things are cheap in reality, and you pay a fortune for them. Great profit margins for the manufacturers.

[LaDiva]

Wahoo Tankie! Good news even if you are overflowing! Can you feel the plugs and do they bother you when you move your eyes? Congrats!

[patientpatrick]

Thanks tankie. Please keep us updated on your progress. I've been very nervous and on the fence about plugs. I've read horror stories of DCR surgery and plugs falling out and getting stuck in the eye. Seems like there are complications for everything. I'm so happy it's working out for you though. If you ever find out the brand of plugs please let me know. Seems like there's a lot to choose from and I'd like to try one that works.

Patrick

[Tankie]

Will do Patrick, although unfortunately I don't really have a way to finding out the brand for you. The doctor is away for Christmas now.

LaDiva, at times they bothered me a little bit, but the last 48 hours I haven't noticed them. I think they've settled in nicely at this point.

[Mawsky]

Your right I'm jealous as all get out, this was my issue before I had DCR surgery, which I think led to my problem now. Tankie, I can't cry a tear at all!! I know that it is frustrating on the flip side too, because I've been there, the worse part I thought was how it blurred my vision, especially when looking downward. I did have to dab my eyes a lot back then. Frankly I'd give anything to reverse my situation now. I'm wondering if it will improve with time, like your eyes getting use to it? I hope so, keep us posted on your progress.

[Tankie]

Thanks Mawsky. I 100% know you know where I'm coming from since you mentioned the "looking down" part. That's the hardest part for me too.

I'll keep you posted.

[mgshutterbug]

Tankie, I'm so glad your pain is gone! I pray the success continues. I've had my lowers plugged for about 4 months, they don't hurt at all, and did help some with the dryness. But then in past 2 months, I started having more RCEs alot closer together than had been happening. 2 in 2 1/2 weeks most recently. My doc and I am conjecturing that it might be because 6 weeks ago I began working in a nursing home, which has forced hot air. And many of the patients have temperature turned all the way up because they get so cold. So staying in their rooms for any period of time makes my eyes practically shrivel up. I've had to spend an hours or so in 2 patients rooms in the past 2 weeks, and we're wondering if that's the cause of the increased rate of RCEs. So she recommended plugging my uppers, see if that made any difference. Well, my eye is much more comfortable, not screaming in pain all the time like before, but I have such tear overflow that my eye is too blurry to use both eyes on the computer. That makes me slower at doing documentation, which really impacts my job performance.

Anyone who has had upper and lower plugs in, and had tear overflow, did the tear flow ever normalize? If so, how long did it take? I'm one week out, and am going to ask my doc next week what she thinks. I can't work with it like this, though it's incredibly wonderful to not have all the pain.

[patientpatrick]

Hi Tankie. I just went to see a Dry Eye specialist yesterday for a dry eye exam. I was told I have an aqueous deficiency I scored a 9mm on a Zone Quick test normal is 20mm+, I was told that the Schirmers test isn't very accurate. This is very depressing. He stated that plugs may not be a good idea because i also have MGD. I believe on your posts you stated you have MGD as well. Do you have MGD and aqueous deficiency? Seems like plugs may help the aqueous deficiency but would make the MGD worse. Any advice?

Thanks Patrick

[Tankie]

Hi mgshutterbug,

With regards RCEs (recurring corneal erosions) I would recommend trying out Muro-128 eye drop. I absolutely love this stuff, I use it every day, even now, especially first thing in the morning and last thing at night. It is used to treat corneal edema (even though to my knowledge I don't have this) but it also makes your eyes more porous so fluid can come through your actual cornea, so you have both your lacrimal glands and your porous cornea lubricating the eyes.

Hi Patrick,

I only suffer from MGD, I do not have aqueous deficiency. I would not say that plugs would make MGD worse, in fact quite the contrary, because without tears in the first place, what can meibum prevent from evaporating?

Consider two situtations.

Scenario A (without plugs):

- Between 1:00pm and 2:00pm your glands for whatever reason produce a decent amount of meibum. Your eyes feel pretty good during this time, however, because you don't have plugs, the meibum drains away through the ducts.
- Now between 2:00pm and the rest of the day your glands for whatever reason don't produce much meibum. Your eyes feel terrible during this time since your tears evaporate immediately or drain through the ducts.

Scenario B (with plugs):

- Between 1:00pm and 2:00pm your glands for whatever reason produce a decent amount of meibum. Your eyes feel pretty good during this time, your tears do not evaporate, your tears do not drain away, and the only problem you face is tears streaming down your face due to overflow.
- Now between 2:00pm and the rest of the day your glands for whatever reason don't produce much meibum. Your eyes should still feel pretty good, because while your tears will now evaporate, at least they won't also drain away, so you should have a layer of watery tears protecting your eyes at all times.

The point I'm trying to make is that plugs should help.

[hkgcomet]

>>>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.

I got 1 eye fully pluged, 1 eye half pluged.
My pluged eye got 15mm tears, but actually just few drops of tear would runs out a day, and it is totally not enough when outdoor.

If your eye is a pool of water and tear runs out every 2 mins, I THINK YOU GOT NORMAL TEARS...ask your doctor and try to remove 1 plug. That's the way to cure, you should now know a deadly pool of water totally different from a normal eye.

[Tankie]

Hi hkgcomet,

I half agree with you. You see, without any plugs I don't get enough tears, but with the plugs I get too many.

DCRdryeye and Robster suggested above that I try these: http://www.dryeye.org/flow.htm

They are plugs that essentially allow you to change the size of the hole leading to your tear duct, anywhere from a diameter of 0.2mm to 0.5mm.

[patientpatrick]

Hi HKgcomet.

I'm a bit confused by your post. I'm not sure what you mean by "normal tears" and a "deadly pool of water" can you explain

Thanks,
patrick