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?

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

[patientpatrick]

Have you tried plugs before? Did you notice a difference with them? I'm quadra plugged and have noticed that my eyes scratch less and I've been using drops less? I think the burning has increased though.

Do you have MGD? I have, and I talked to my dry eye doc about that and he advised against it because he said it could alter the shape of my lids and cause further inflammation. I wonder if you are experiencing a bad case of inflammation, some patients here said it took a few weeks for that to go down before they noticed relief.

P

[DCRdryeye]

Having the lowers either plugged or cauterized may not be enough to retain tears simply because you're not producing enough tears. Try temporary plugs in the upper puncta's and see if that makes a difference. Many Dry eye sufferers need to be quadra plugged.

Patrick, you have a smart doctor. I've had DCR surgery and had dry eye ever since. I assumed it changed the shape of my eyelids that led to the symptoms - seems like I could have been correct. Part of the surgery involved cutting and dilating the puncta's and keeping a tube in them for 2 months.

[lizzyk]

Patrick, i did have plugs and initially they did help but over time i think i became sensitive to them and removed them.
My doc (who is not terribly empathetic) tells me i no longer have blep and my glands are not blocked. Which is strange because when i press on my eyelids it looks creamy and thick to me but of course i can only see this with a hand held mirror and not with a microscope!
I will give it a few more weeks as you suggest and hopefully i will notice an improvement.

DCRdryeye, i intend to ask for temporary plugs when i next see my doc, i just hope they are not made from silicone - which is what i think i have become sensitive to!

[patientpatrick]

It's hard to find an empathetic doc for dry eye, to them dealing with dry eye is more of a nuisance than other issues. I've found being a step ahead and being proactive with treatment has been more successful than leaving things up to doctors. Have you noticed your mgd getting worse after cautery?

You can get a 20x mirror from amazon btw. I even found a 10x ne at the 99 cent store of all places. It's allowed me to express my own glands which has improved my sensitivity to wind somewhat

P

[DCRdryeye]

You can put up with some wind now patrick? wow, that'd be awesome, I'd be in agony without my Wiley X glasses on. Did you see this blog:

http://www.dryeyezone.com/talk/showt...and-expression

Apparently, a top ophthalmologist told me he threw out his Mastrota paddles in favour of the Collins MG expressor forceps. I'd love to purchase it myself and use it.

[patientpatrick]

I still have to use eye protection when I go outside, but being inside with mild AC has become more tolerable. I thought about buying these forceps, have you tried them? I have a pair of silicone tip tweezers which work decent for the lowers I also have a paddle which seems troublesome to use at times. Doing the uppers is very difficult. I'm trying to find something that would allow me to do it myself comfortably.

[DCRdryeye]

I haven't tried self expression and would like to purchase the Collins MG Expressor Forceps unless they only sell to ECP's ?