Punctal Plugs or Scleral Lens?

[dryboy]

Hey! I have a diagnosis of evaporative's dry eye because of a dysfunction in the meibomium glands. I've gone through all the initial treatments: eye drops, gels, compresses, diet, exercise, supplementation, etc. I've also had 4 IPL sessions and currently use Restasis. I have even put 2 plugs in my lower tear ducts, which were expelled in one month (the doctor used a kind of superficial plug but suppose to be definitive, it was not the intracanalicularly plug type). Well, now I've got a new doctor and finally found someone who seems to be willing to help me out and not sell me more stuff from their clinic.

The pont is that I really need greater comfort when I'm in front of screens, specially PC (to continue following with my studies and my dreams - there's no way I can change that while I'm alive and healthy). For that, I was wondering if it would be more appropriate to do the scleral lens test or try a tear duct cauterization, maybe a new chance with the new intracanalicular plugs - these are the main options i haven't tried yet.

What do you think about this? Plugs are apparently much more practical, but i'm reading that ppl are much more successful and comfortable on screens with ecleral lenses.

Thank you so much if you can share your experience with me.

p.s.: I did my best with the english, and I hope I made myself clear. I'm from Brazil.

[Rebecca Petris]

Hello and welcome! Your English is great

Can I make a few non-medical suggestions for computer use? These may be things you've tried already, but just in case.

1) Moisture chamber glasses! These can be fancy ones (like zienaeyewear.com) or safety goggles or anything that will close in your eyes. This raises the humidity very high in the space immediately in front of your eyes and helps compensate for evaporative tear loss especially during screen use when you are not blinking enough. Many people with dry eye uses these whenever they are at a computer, or outdoors to protect from wind.

2) Adjust screen position: You should be looking slightly downwards if possible - rather than straight or upwards. This helps keep your lids covering more of your eye surface.

3) Blink reminders / blink exercises

4) Desktop humidifier maybe?

About intracanalicular plugs: I would advise you to be *very* cautious with these unless they are dissolvable. Durable intracanalicular plugs can become lost and cause harm. It doesn't happen often but when it happens it's very difficult to fix.

Scleral lenses are great but they are also a big lifestyle change, they're costly, and sometimes it's difficult to find a provider with the right skills for our particular needs. They also don't always solve everything, for example, some people use moisture chamber glasses over sclerals. But definitely a good thing if other options aren't working!

Good luck!

[dryboy]

Hello and welcome! Your English is great

Can I make a few non-medical suggestions for computer use? These may be things you've tried already, but just in case.

1) Moisture chamber glasses! These can be fancy ones (like zienaeyewear.com) or safety goggles or anything that will close in your eyes. This raises the humidity very high in the space immediately in front of your eyes and helps compensate for evaporative tear loss especially during screen use when you are not blinking enough. Many people with dry eye uses these whenever they are at a computer, or outdoors to protect from wind.

2) Adjust screen position: You should be looking slightly downwards if possible - rather than straight or upwards. This helps keep your lids covering more of your eye surface.

3) Blink reminders / blink exercises

4) Desktop humidifier maybe?

About intracanalicular plugs: I would advise you to be *very* cautious with these unless they are dissolvable. Durable intracanalicular plugs can become lost and cause harm. It doesn't happen often but when it happens it's very difficult to fix.

Scleral lenses are great but they are also a big lifestyle change, they're costly, and sometimes it's difficult to find a provider with the right skills for our particular needs. They also don't always solve everything, for example, some people use moisture chamber glasses over sclerals. But definitely a good thing if other options aren't working!

Good luck!

Hey Rebecca! Thank you very much. I see you've always been so receptive here and that's makes us feel more welcomed.

I already test all the options that you say about, except the chamber glasses. Unfortunlly, here in Brazil we don't see those types. But I'm reading that is very common there. I'm gonna try to find those ones on internet, if you have some types on a website who could to deliver to Brazil (like Amazon) i'll be very grate.

The things that you related about the punctual plugs is what made me wanna try more the scleral. I'm reading a lot of bad things about de plugs, and maybe the scleral could be an option safer (I mean, with less risk of complications).

Thank you again, and just remember if you know some website who could sell the chamber glasses and made internationals orders (to Brazil) i'll be very, very, gratefull to know.

[Rebecca Petris]

So the most popular moisture chamber glasses are Ziena Eyewear. I am pretty sure they do not ship internationally but we will find out and we'll try to track down a dealer that does if the manufacturer does not themselves.

Wiley-X makes some glasses (see their Climate Control series) that are very popular for dry eye. They are designed for outdoors but I know plenty of people who get clear lenses put in them and use them for computer work. Their website seems to indicate that they ship internationally
https://www.wileyx.com/americas

https://www.wileyx.com/sunglasses/co...limate-control

The difficult thing of course with purchasing over the internet is ensuring a good fit. The manufacturers can sometimes help with recommendations though.

[Rebecca Petris]

Good news - my assistant Cindy checked with 7Eye and they ship to Brazil! 7Eye makes both the Ziena Eyewear and the 7eye airshield glasses.

[dryboy]

Good news - my assistant Cindy checked with 7Eye and they ship to Brazil! 7Eye makes both the Ziena Eyewear and the 7eye airshield glasses.

Hey, Rebecca! Thank you VERY MUCH for that. I'm gonna try this. Again, thanks!

[Rebecca Petris]

You are so welcome

[wolflos]

Hi there. I'm also from Brazil and bought a 7eye glasses in 2021. It's a good product. The problem is that you cannot try it first, so mine wasn't so well adjusted. I ordered mine with blue light protection. After a while, I found out reading some articles that blue light can be a problem to many people with DED. In my case, I have neuropathic ocular pain, so it's even more intense. I got better with the glasses, so I bought another one in ocushield.com , that is not a chamber, but it's the best of the world in its category of blocking blue light. I don't know if it's psychological, but putting a blue light shield screen on my iPhone and using a blue light shield glasses at computer really improved my symptoms...