Reflex tearing with all four punctum plugged?

[kitty]

Has anyone experienced reflex tearing while being quadriplugged? If so, I would like to know how you managed it. Did you keep your plugs or get rid of some? Or just have them repositioned? What ended up being the cause and the fix? Is this just another trial and tribulation of DES?

[indrep]

kitty,
Some people on being plugged will tear more for a short period of time( two weeks) then it will settle down. If it does not settle down to a manageable level, you might consider the Flow Controller plugs as replacements for one set of plugs. I hope the excess is giving you some relief.

[dianat]

Kitty,

When you say "reflex" tearing, I understand that to be a salty, responsive tear that accompanies irritation of the eye. I had this happen to me when I had upper plugs in place.

The upper plugs, which I kept for at least two weeks or more until they fell out, were apparently rubbing on my sclera and causing a great deal of reflex tearing. The lowers were very comfortable, but weren't very effective by themselves.

Anyway, it's shocking how miserable I was with all four punctae plugged. Due to the rubbing of the upper plugs on my eye, I burned badly from salty, reflex tears and had a lot of extra fluid, sometimes dripping down my face. I never really understood what was really happening until much later. My LASIK surgeon was the one who placed the plugs at my insistence. His expertise unfortunately didn't extend into issues of the severely dry LASIK patient.

As said, the upper plugs fell out and I was honestly much better without them. Had I been wearing upper plugs that were not irritating my eyes, likely I'd have fared a lot better.

Ultimately, I opted to have all four punctae cauterized. My lowers were cauterized first, but weren't effective so I opted to have the uppers done. I do have an overflow with all four, but this is much, much different than the reflex tearing. It's more comfortable and there isn't near as much fluid. I manage it by blotting all day long. It's not ideal to blot all the time, but the options are to have bone dry eyeballs where my eyes can barely blink and my lids skip across my eye.

Kitty, if you really feel you are experiencing reflex tearing, I recommend remedying this as soon as possible. If you just have an overflow, then I would consider indrep's post.

Diana

[kitty]

Thanks guys. I am fairly certain that this is reflex tearing, not just overflow. The tearing comes in spurts and is associated with stinging, burning and intense itching. The itching is not relieved by Patanol. I was at the dentist yesterday and he really freaked out thinking he was hurting me when he saw a tear roll down my face! I got the upper plugs 3 weeks ago. The left eye has quieted down as far as the tearing, but nothing much else has changed. I am on a medication that can cause dry eyes, so I am taking a few days off of that to see if there is any improvement. I did have some plug awareness after the uppers were first put in, but that resoved in a week or so. It could be that I am still experiencing plug irritation. I have intracanalicular plugs so that makes things a bit more complex. It looks like I have waited long enough to let things quiet down after the upper plugs went in. It seems I was alot more comfortable with the temporary uppers than with the permanent ones. Of course, those were not put in during the winter season with the heaters running! After the 3 day drug holiday if I am not better, I will go see my doc again.

[dianat]

Kitty,

I failed to mention that when I had the reflex tearing issue with the upper plugs, the dripping and such would intensify at certain times of the day sending tears streaming down my cheeks. Most of the day I was simply watery, miserable and burning. I would get the occasional "rain shower" for no apparent reason. It's much like what you're describing.

It was a really confusing thing at the time since I was a newbie at all this and had no support from anybody who was wise to it all. My LASIK doctor thought I was exaggerating. It's actually really sad for me to think back on it all; it was so hard on me. I've sure come a long way.

Diana

[kitty]

Thanks for the help, DianaT. "Rain Shower" is a perfect analogy! You have indeed come a long way! Eyes are so darn frustrating. It seems that most every eye affliction has the same book of symptoms. It's so hard to sort out what is what!