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Punctal Cautery - Inflammation?

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  • Punctal Cautery - Inflammation?

    So I talked about punctal cautery with one of my eye doctors and he's very opposed to it. He stated that by burning sensitive tissue on the eyelids it could cause a cascading effect of inflammation that could make people suffering from eyelid disorders such as MGD even worse off then before. I know that this might bepouring salt on a wound to anyone who had a bad reaction to punctal cautery but has this procedure made anyones eyes worse?

  • #2
    My eyes get temporarily worse after cautery... I don't doubt that burning that eyelid tissue causes inflammation!!! In the first 2-4 days post-cautery, my eye will be more prone to redness, and even though my eyes are positively dripping with tears at that time, they can't tolerate much reading, computer use etc.

    However, I've been lucky because as long as I baby my eyes a bit more during that initial healing period (maybe 2-4 days), they end up better off than before cautery due to all those extra tears and I go back to life as usual, but BETTER, since I'm now able to tolerate MORE reading and computer use compared to before.

    I think the trick is to baby the eyes during the initial healing so that any post-cautery inflammation doesn't put you into a downward spiral eye-wise. Never any guarantees, of course, but I guess all you can do is stack the odds in your favour, right?

    Also, I wonder how often the dr. that said this actually performs cautery? Wonder how much of his reservations are due to not being comfortable with performing the procedure in the first place?

    Cautery is an accepted part of the dry eye treatment guidelines, and if it made most people worse-off, I don't think it would be in there.

    For sure, there is risk though. I've dreamt up them all haha... what if the dr's hand slips when he's doing it and it burns my eyeball? What if I sneeze when he's doing it and my eyeball gets burned? What if my eyelid gets totally screwed up from it and never closes properly ever again and then I'll have MORE problems? and on it goes... In my case, I figured since the dr's who have cauterized my lids have done it many times before, odds were that they wouldn't screw up and hurt me (no guarantee, but good enough odds for me to go through with it... desperate times call for desperate measures and all that...)

    Also, if the procedure inflamed the eyes ridiculously much, then that's what steroid drops are for, no? Odds are you'd never need them, but surely a dr. could prescribe them in the event of a freakishly over-sensitive reaction to the procedure...

    And if he's worried about the whole toxic tears thing, then that's a whole other story. If you can, having an "out" is good. ex. permanent umbrella-style plugs in your lowers, cautery in uppers. If cautery made things worse due to toxic tears, you can have the lower plugs removed.
    Yet another post-Lasik (2005)...
    Anyone have a time machine so I can go back and undo this mess?

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