Cauterization

[lizzyk]

I have both my lower puctum cauterized last week and so far i have no difference to the dryness i experience

does anyone have any ideas/advice please?

[lizzyk]

This may sound daft but could my own tears be causing me irritation?

[farmgirl]

Did you have plugs before the cauterization and if so did they help?

[lizzyk]

Yes i had plugs and initially they did help but then my eyes started to feel worse, so i thought i was sensitive to the plugs and removed them.
Is cauterization reversible?

[patientpatrick]

I've heard that superficial cautery is reversible but not recommended. Which is probably why I have not gone through with it yet. While my plugs are bothersome they do help relieve some of my symptoms. I've had to replace a few of them over the last few months. Either the doc used plugs too small, or the plugs are stretching and enlarging my puncta.

P

[NotADryEye]

I've heard that superficial cautery is reversible but not recommended. P

It depends on how it's done. My lower puncta were cauterized very deeply. The procedure is reversible, but with difficulty and there is the risk of scar tissue. Sueprficial can be reversed in the office. But again, it depends on how it's done, skill level, etc.

[NotADryEye]

This may sound daft but could my own tears be causing me irritation?

Yes, but it depends on the quality of your tears. If you secrete a lot of free fatty acids, for example, like I do, your tears can feel very soapy and very uncomfortable - saponification happens when the ffa's mix with the proteins in the tear film and turn into soap.

Also, if you have epiphora, the tears do not feel good coming down, especialy as it hits any fragile mucous tissue like in the corners of the eyes. The tears are concentrated, not like when you cry and the tears are diluted. Also, I've found that different emotions cause different sensations in the tears. For example, if I have emotional tears that are caused by something nice e.g. tears of love, my eyes feel better, almost soothed. Angry tears, on the other hand, feel awful.

I've wondered sometimes if a daily 2-second dose of a good emotional movie would be a better way to irrigate the eyes rather than using the .9% saline solution, although I stopped irrigating recently and am feeling pretty good, so not bothering with the quick emotional cry test.

[lizzyk]

Thanks all, i will give my eyes a few weeks to settle down and see how it goes, fingers crossed for some improvement.

I can just picture my (unsympathetic) doc's face if i suggest my own tears might be causing me problems - he will be incredulous!!

And if i ask for a reversal i think he might throw me out of his office!!

Patrick how do manage to get enough pressure on your eyelids (without hurting yourself) to express your glands and how do you wipe away the goo?