New Scleral Lens Wearer

[Lucy]

I saw my doc and he said that the cauterization was intact. So, no re-burn. My puncta will not accept SmartPlugs, or it seems now, any other kind. I'm pretty scarred in the area from multiple pluggings.

You explained very well your reason for having your plug removed. I'm so far into the process, my natural scarring has pretty much taken over.

I do have a plug or two still in place. Not sure which. Also cauterized in one and a "natural cauterization" in one.

[green eyes2]

Hi Lucy,

I have a SmartPlug in the left lower punctum. It is not likely that it will come out on its own because it is an intracanicular plug that has to be irrigated out. The plug I had in the right eye was just a silicone plug with a cap and that one had popped out. The SmartPlug does not bother me at all. I do not even know it is there and my Schirmer is normal in that eye (though my TBUT is not). The reason I want the plug removed is because I believe it is causing cloudy vision in my left scleral lens and Dr. Rosenthal concurred that is the probable cause. He also mentioned that the plug is contributing to a low-grade inflammation allowing the inflammatory mediators to be retained on the eye, which does not sound good to me at all. I will wait before deciding, though, as my vision did not become cloudy today.

I hope your recauterization went well. If not, have you ever considered asking for a SmartPlug? They work really great. The doctor doesn't have to dilate the punctum and it's very easy and painless to have inserted, there is no cap sticking out and it expands to perfectly fit in your punctum and should stay put.

[Lucy]

so it wouldn't hurt anything for me to have the plug removed.

Green eyes, if this plug is not bothering you, I'd leave it in place. Eventually, it'll come out on it's own, or you'll have it removed on purpose. Why mess with something that is working, at least this early in the game with your new Boston lens?

Last winter, I had a foreign body in my eye and I was going crazy. I didn't know there was a foreign body, though. I went in and told the doc to remove the upper plug and look under my eyelid. Unfortunately, he removed the plug and THEN flipped the eyelid revealing a speck of sand (or similar). This simple move took a big toll on that eye. He has not been able to get another plug in there and I've been cauterized since. I don't think the cauterization healed because I notice no improvement. I am going back tomorrow to see if he will re-cauterize that upper duct again.

After you've become accustomed to your new lens and how you wear them, then you might want to consider it at a convenient time. I just hate to see you have a plug removed "just because" and then have your tear balance go south on you.

Lucy

[green eyes2]

The sclerals should work if you have your ducts cauterized, but you may have to remove the lenses after a few hours of wear and refill them with saline depending on if enough debris accumulates in the lenses to cloud your vision. This can happen because if you have abnormal tears there is debris present. If you have excessive debris it will be sucked up into your lenses and cloud your vision. That's why some people have to remove the sclerals and refill them. The waiver you sign at the clinic states it may be necessary for you to remove and refill the lenses periodically throughout the day. Yesterday, my vision in the left eye did not cloud so I'm not sure what is going on..adjusting to them or tear quality better yesterday..very confusing. Honestly, I can't really tell any difference between my eyes and my Schirmer without anesthetic was 12 in the left eye (which has one lower plug) and 5 in the nonplugged right eye, so it wouldn't hurt anything for me to have the plug removed.

[Silverlady]

Question

I wonder if the Sceleral will work on people who have lower ducts cauterized?

Billye

[Rebecca Petris]

In the short time I have had the lenses, I can say my attitude has changed dramatically for the better and I am not having any more burning eye pain. These lenses also have a therapeutic effect because when I remove them my eyes feel great for a few hours and better than normal when I wake up.

Love to hear this... very encouraging and long may it continue!

Sounds like you are experiencing exactly what I do after removal.

Interesting about the plugged eye - keep us posted! And thanks for all the detail on the visit. Posts like yours and Erik's are so helpful to people who want to know what it will be like.

[green eyes2]

Hi DianaT.. Idiopathic is a medical term that just means of unknown cause. It can apply to any condition. I have no clue (nor does any doctor I've ever seen) as to what could be the cause of my dry eyes, as thankfully I am otherwise very healthy.

[dianat]

I am exited to see this post! I'm happy for you that you made the trip. It's great to have a fellow dry-eye sufferer take a step in the right direction! What exactly is idiopathic dry eye?

[green eyes2]

I am wearing the Boston scleral lenses right now. I just got home from Boston a few days ago and have been waiting to write about my experience because I wanted a little time to adjust to the lenses first. With all contact lenses (even soft lenses) there is an adjustment period. The adjustment period with new RGP wearers is much longer than with soft lenses, especially in terms of comfort. I am definitely still adjusting to them.

The reason I got the lenses is due to idiopathic dry eye. Most the other patients while I was at Boston Sight had dry eyes. The other patients dry eyes were due to cancer (leukemia), Stevens-Johnson syndrome, anesthetic cornea from shingles, and one lady with both keratoconus and dry eye. There was also another lady there who had idiopathic dry eye like myself. I was in Boston for a total of ten days (they do not see patients on weekends) and it took the entire time to ensure that I got the proper fit. I was fitted by Dr. Johns and Dr. Rosenthal, who are both excellent and very caring. The clinic is very nice and has a kitchen, quiet room, and media room to relax in while you are there. There is a CVS, a small grocery store, and a Starbucks within walking distance. Also within walking distance is the "T", which is public transportation to various places in Needham and Boston, etc. I spent most my time in either the kitchen or quiet room and just talking to other patients. I could not see very well and at times was quite uncomfortable with the trial lenses on, which is part of the fitting process and what you will have to wear before you get lenses made with your actual fit and prescription.

While in Boston I stayed at the Sheraton Needham hotel and took the free shuttle to and from the clinic or caught a ride with patients who had a rental car. The free shuttle will take you anywhere within a 5-mile radius of the hotel. The Sheraton is a very nice hotel with free continental breakfast and in the evening free hors d'oeuvres on the 5th floor (not all hotel guests have access to this, but this is a perk for being patients of Boston Sight). There is a great exercise room with treadmills that have a built-in-tv (take your headphones to plug into it..the hotel has earbuds but it took me two days to get some), stairmaster, and bikes and free weights and also a heated swimming pool. They have a lot of cable channels to watch and movies you can order. They also have room service, but it is very expensive. I only ordered room service once. You can also eat at the clinic for free. You should have a refrigerator at no charge in your room since you are a patient, if not request one. If you want a microwave I am sure you will have to pay a fee. I did not have one. The Sheraton is $99/night for patients. If coming from the airport you will need to either take a taxi (about $60) or make reservations for The Airporter ($45). You can stay at a hospitality home for free if you can't afford the hotel. You will need to make arrangements for a hospitality home with Bill Rosenthal.

In the short time I have had the lenses, I can say my attitude has changed dramatically for the better and I am not having any more burning eye pain. These lenses also have a therapeutic effect because when I remove them my eyes feel great for a few hours and better than normal when I wake up. I had some issues with clarity of vision in my left eye, but I do not know if that is due to debris getting under the lens or if it is because I am adjusting to the lenses. Dr. Rosenthal said I may need to have the plug in the left eye removed. I do not have a plug in the right eye and vision has been fine in that eye. The lenses were feeling very tight and uncomfortable at first, but today they actually are starting to feel more comfortable. I am very happy right now that I went to Boston. I will continue to update. If you have any questions, feel free to ask.