I'm scared! Stringy tears - hard palate grafts or ??

[eyes78]

You may have read this on my other post but here is a summary.

As part of my dry eye treatment, in November 2009, I had strips of my hard palate (roof of mouth) grafted into the inside of my lower eyelids, to raise my lower lids so they would cover more of my eyeball surface.

Before the surgery, my surgeon, Dr. F, told me that about 1 in 10 hard palate graft patients experience stringy tears due to the fact that there are salivary glands in the hard palate tissue.

I didn't really think much of that until a few months ago when I started experiencing increasingly worse periodic bouts of stringy tears that would blur my vision. At first it was just annoying, but it got to the point where it would happen in BOTH eyes, while driving!

I called Dr F's office and they called in an Rx for Tobradex (antibiotic/steroid combo). I took it for a week, it made no difference, they told me to stop. Since they can't get me in until 4/4, they told me to see my regular eye Dr in the meantime to rule out infection.

So I saw my regular opthalmologis, Dr R, yesterday. He didn't buy my saliva theory at all, instead he was feeling my eyelids saying he detected lots of inflammation. Uh, no, I believe that is the GRAFTS you are feeling. I told him my eyelids feel no different than they ever have since the surgery. I also have no swelling, no pain, no itching.

Nevertheless, he prescribed a VERY strong steroid - Durezol. He said he thinks my eyes are reacting to a foreign body (the grafts) and the steroid should calm them down.
I asked - but if my problem is a reaction to the grafts, what happens when I stop the steroid? Won't the problem just return? He said maybe, and that if it did, I would need to get the grafts removed.

BUT I NEED THEM!!

So anyway, I took the Durezol, it burned like hell for a minute and then I felt this weird pressure/pain behind my eyes all evening. But - there were no more stringy tears!
So I took another dose this morning, and I've had a relatively stringy-tear-free day.

But I'm practically overcome with anxiety right now - the way I see it, there are 3 possible outcomes:

1. I have some weird thing going on in my eyes, unrelated to the grafts, and the steroids will cure it. (best option)
2. The grafts are producing the stringy tears with the salivary glands, and Dr F will need to take them out and replace them with another material (ok option)
3. My eyes will react this way to ANY graft material and I am out of luck (Freaking out option)

I know my appt is only 3 days away but I am seriously not handling this well. I'm so scared.

Any thoughts would be appreciated. Thanks all.

[Mawsky]

You may have read this on my other post but here is a summary.

As part of my dry eye treatment, in November 2009, I had strips of my hard palate (roof of mouth) grafted into the inside of my lower eyelids, to raise my lower lids so they would cover more of my eyeball surface.

Before the surgery, my surgeon, Dr. F, told me that about 1 in 10 hard palate graft patients experience stringy tears due to the fact that there are salivary glands in the hard palate tissue.

I didn't really think much of that until a few months ago when I started experiencing increasingly worse periodic bouts of stringy tears that would blur my vision. At first it was just annoying, but it got to the point where it would happen in BOTH eyes, while driving!

I called Dr F's office and they called in an Rx for Tobradex (antibiotic/steroid combo). I took it for a week, it made no difference, they told me to stop. Since they can't get me in until 4/4, they told me to see my regular eye Dr in the meantime to rule out infection.

So I saw my regular opthalmologis, Dr R, yesterday. He didn't buy my saliva theory at all, instead he was feeling my eyelids saying he detected lots of inflammation. Uh, no, I believe that is the GRAFTS you are feeling. I told him my eyelids feel no different than they ever have since the surgery. I also have no swelling, no pain, no itching.

Nevertheless, he prescribed a VERY strong steroid - Durezol. He said he thinks my eyes are reacting to a foreign body (the grafts) and the steroid should calm them down.
I asked - but if my problem is a reaction to the grafts, what happens when I stop the steroid? Won't the problem just return? He said maybe, and that if it did, I would need to get the grafts removed.

BUT I NEED THEM!!

So anyway, I took the Durezol, it burned like hell for a minute and then I felt this weird pressure/pain behind my eyes all evening. But - there were no more stringy tears!
So I took another dose this morning, and I've had a relatively stringy-tear-free day.

But I'm practically overcome with anxiety right now - the way I see it, there are 3 possible outcomes:

1. I have some weird thing going on in my eyes, unrelated to the grafts, and the steroids will cure it. (best option)
2. The grafts are producing the stringy tears with the salivary glands, and Dr F will need to take them out and replace them with another material (ok option)
3. My eyes will react this way to ANY graft material and I am out of luck (Freaking out option)

I know my appt is only 3 days away but I am seriously not handling this well. I'm so scared.

Any thoughts would be appreciated. Thanks all.

Hi, so sorry that you are going through all this, I would be concerned too. Not knowing what kind of dry eye problem you had to begin with, it's hard to say, but did you have stringy tear prior to this at any time? The reason I'm asking is that I had stringy strands, that would often blur my vision several times a day I would have to fish them out, this was before I even had an inkling I had a dry eye issue. When my dry eyes became sever the stringy tear disappeared right now I'd love to have just that problem again some days my eyes improve somewhat and I notice a bit more of the mucous strands appearing. I asked the surgeon who may be doing a surgery to permemently close my punctum, about the stringy tears I had had, and he said that was from a lack of wet tears, so my question would be this, do your eyes feel better? are they no longer as dry? Maybe this is a inbetween stage, where you are not severly dry but not enough tears (wet) are being produced. Just a thought, of course you will know more I hope when you see the Dr. Please post so we know what he/she says. Best of luck with your visit.