DCR Surgery for blocked tear duct

[carole A. Lockilin]

I have experienced dry eye syndrome for about 13 years. My original optomologist blocked both of my lower tear ducts about 10 years ago after no relief from eye drops. Eventually these punctum plugs either became dislodged and fell out or became imbedded in my tubes. I am not sure what happened but both of my lower punctums became scarred over.

I went from dry eye to experiencing excessive tearing (overflowing) in my left eye starting in October 2005. My right eye tears but less so. My new optomologist advised me to have a punctoplasty to open up the blocked tear duct in my left eye and attempt to clear any obstruction in my tear duct. This failed to offer any relief as the tear duct is apparently blocked further down.

He then referred me to a specialist (Occulist) who wants me to have a DCR to clear the blockage. This requires a small incision on the bridge of the nose into the nasallacrimal duct.

Right now, I have put off surgery because the weather is warmer and more humid and my overflowing has pretty much ceased. I do, however, have watering in both eyes but not nearly as bad. I must assume that this condition will get worse once again when the colder, dryer weather returns.

Go figure, how do I go from dry eye to this situation...and is this all a part of the punctum plugs, scarring or a part of dry eye.

Any comments!

[Cindy]

By Carole:

Go figure, how do I go from dry eye to this situation...and is this all a part of the punctum plugs, scarring or a part of dry eye.

I don't know. I also have an imbedded plug but I do not have tearing in that eye at all. I'd like to know what research you have done about DCR and if you would please share it. I've been a little bit worried about my imbedded plug and how in the heck it can be removed. I've opted to leave it primarily because it doesn't cause me any major problems and I'm a little twitchy about having surgery to remove it. Sometimes it gets itchy and swollen but so far (knock wood) the symptoms go away.

I can't help but wonder why something like this darn plug would have been put in my punctum and now can't be removed or even seen now that it has migrated further into the canal. IMHO, docs shouldn't put anything in that they can't take out.

[jcorbett]

Cindy - if the plug cannot be seen, how do you know it didn't just fall out? Just curious. Is this common? Did you have one of those plugs that don't have a little knob sticking out? Can't remember what they call them....smart plugs??

[Lucy]

Cindy - if the plug cannot be seen, how do you know it didn't just fall out?

Yes, Cindy, how do you (we) know for sure?

I tell the docs I go to now that my lowers are scarred shut. This has about as much influence as me telling them I have dry eyes. Come to think of it, I'm not sure if I'm scarred shut, or if I have failed plugs stacked up in the canal and the doc just kept putting another one in. Stack em up.

[Cindy]

Cindy - if the plug cannot be seen, how do you know it didn't just fall out? Just curious. Is this common? Did you have one of those plugs that don't have a little knob sticking out? Can't remember what they call them....smart plugs??

One or two years ago (can't remember, time flies) I wanted to have plugs put in my lower puncti. I had had them before and just assumed they fell out. Before doing it, my OD sent me to an ophthalmologist to have my ducts irrigated just to make sure the plugs were gone. The irrigation showed that my lower left was still blocked but they couldn't see the plug. The right flowed freely. I had Herrick plugs. The doc assumed the plug had migrated deep into the canal and so would not put in another. Herricks are very comfortable in that they don't stick out. That's the upside...the downside is that if they go into the canal and become imbedded, they can't be seen. The only way to find out if they are still there is to flush the ducts.

[jcorbett]

From the smartplug website:

Medennium estimates that the punctum plug market for the dry eye therapy amounts to appoximately $30 milion a year in the United States. The rapid growth is primarily due to LASIK induced dry eye, which is increasingly being treated with punctum plugs.

At least someone out there is recognizing the Lasik-dry eye connection.

[Lucy]

At least someone out there is recognizing the Lasik-dry eye connection.

Indeed! If there is a buck to be made. I guess that is a good thng. The drs have no incentive to address our problems as it just emphasizes there ARE PROBLEMS.

[Lisa2]

Hello,

Your story is similar to mine. I'm new here & just posted a thread about my problem with dry eyes, then plugs, then DCR surgery (left eye).

I don't know where my post is, I stumbled upon your post though.

I had those symptoms of a flooding left eye starting the end of Oct. 2005 as well. My plugs had migrated & the left one was surgically removed from my lacrimal sac with the DCR surgery. It's no little surgery though.
Of course not major open heart or other either, but it took 2 hrs under general anesthetic & 1 full week off work. I'm still on steroid eye drops, antibiotic drops, ointments & eye lubricants throughout the day. I had the worst migraine of my life that I woke up to in the Recovery Room. Partially due to anesthetic, partly due to the area of the surgery & positioning.

I have photos of the entire process from day one of surg if your interested. You can PM me. It was a last resort for me. I had 4 attempts with flushing it out, then one of probing with a wire before we had to do surgery.

My plugs were the Herrick Plug. I'm interested in your type of plug.
I found a Dr. who posted on another board who has seen 9 patients so far w/ this particular type of plug that migrated & needing surgery.

Thanks.

[Lisa2]

I posted more on the Open Forum.

L

[Peggy]

Lisa ,
I sent you a private message will you give it a look when you have a minute. Thanks ,
Peggy