Author Topic: punctual occlusion 2 years ago  (Read 2063 times)

louisa

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punctual occlusion 2 years ago
« on: October 23, 2009, 06:28:02 AM »
hi
I haven not posted on these boards for a while but thought i would catch up. Two years ago i had my tear ducts plugged following months of severed irritation and pain(all the usual stuff). It worked so well for me that i was finding i did not need to use them hardly at all or have my humidifier on, stopped taking the salagen and was able to live more combtably. However, last week i noticed tearing and now i am back to square one! What worries me is that i remember a kind lady from the the uk sjorgrens support who was really badly affected saying that punctual occlusion would only work for a short while and then it would just stop working and that would be that. This was before i had had them done and it depressed me at the time as i really could not cope with the pain. Is this generally the case? Maybe this is my own fault as i have got very complacent about my eyecare because i felt that it had dissapeared. I am hoping that maybe this is just a relapse and like other symptoms i do have(bladder pain) it will come and go. I have put the humidifier on and will start taking the salagen again and back to the wrap arounds!!!!!!!! What is odd is that it did kick off after i used a new moisturiser with a gradual tanning thingy in it(had used others and they were fine). I wonder if it could be this, but my dry mouth suggests it may not as the product would not affect that. Oh darn! Like most of you i was having a hard time coping with the eye thing and of all my symptoms that can be the worst. Would be really gratefull for any help. I do not have antibodies to sjorgrens although my lip biopsy did show mild inflamation and the rheumatologist did say it was prob sjorgrens. I do have diagnosed interstitial cystitis and anti phospholipid syndrome.
Sorry about this long post, love to hear from somebody.
Lou x

Scottietottie

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Re: punctual occlusion 2 years ago
« Reply #1 on: October 23, 2009, 07:38:52 AM »
Hello Lou  :)

I'm sorry you're feeling bad again. Were your tear ducts plugged or cauterised? Plugs can come out I believe. I think the best thing you can do is to consult your opthamologist and see what they can suggest.

I think that keeping on top of eye care is important although it can be slightly time consuming. Maybe it's a flare that will subside.

Take care - Scottie  :)
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ohiolady

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Re: punctual occlusion 2 years ago
« Reply #2 on: October 23, 2009, 08:55:53 AM »
Have you tried Restasis?  I think Scottie is right about checking to see if plugs fell out, that would not be unusual.  I've found symptoms with Sjogrens vary in intensity from day to day but also have periods where I really flare.  You may be experiencing a flare of sorts.

Hope you find a solution that helps.

Anna
SJS  Hashimoto's   Mild Raynauds  GERD  Gastroparesis
Restasis, Evoxac, Dexilant,  Domperidone, Zofran and Synthroid. Fish Oil, Vit D and B12  R lipoic acid,  Acetyl L Cartnine, Vitamin B1, and The Perfect Food Green and Fruit supplement

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louisa

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Re: punctual occlusion 2 years ago
« Reply #3 on: October 24, 2009, 01:19:01 PM »
Thanks to Scottie tottie and Ohiolady for replying to my post. My eyes have had their lower lids plugged in answer to your question and they are still in place.i dont think we have Restasis in the uk? I am quite down as i thought the punctual occlusion would put pay to that terrible eye pain that went on in 2007. Does anybody have their eyes plugged and suffer relapses but do get better? I am looking for reassurance as the lady in the uk said that eventually punctual occlusion stops working?????? I still wonder if during my the last two years when things have been good if i should have applied the drops as often as i used to. Drops and gels just dont work when i am like this, i am wearing wrap around safety glasses and at the mo that is not helping, maybe if i throw everything i have at it, it will settle down again. As i said before i do not have antibodies to sjorgrens but do have antiphospholipid syndrome and interstital cystitis. I have just started taking the oral pilocarpine again and i am still sceptical whether that helped originally or not. Maybe the plugging did not help and i just got better on my own. Anybody had a similiar experience? I just hope this goes again as last time i became very depressed, as i am some of you will be all too familiar with. This has only been going on for a week but already i am in a state.
I do not find the sjorgrens support service very comprehensive or very positive in the uk(sorry if thats offended anybody) but always found these boards helpful. Look forward to hearing from someone.
Lou

hoping

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Re: punctual occlusion 2 years ago
« Reply #4 on: October 24, 2009, 05:59:10 PM »
i had plugs (uppers and lowers) put in within this year.  Found I was tearing too much from the rt. eye so had the upper plug taken out.  I also had a honeymoon period where I did not use anything for eyes.  Restasis never helped before anyway.  Then my SjS got worse, eyes are drier, back to gel drops, small nerve fiber neuropathy is raging, and mouth gets real dry later in day with Evoxac.  Was diagnosed with interstitial cystitis this spring and it has not responded to any treatment.  Also dealing with GI issues.  

I do not know if the honeymoon is over.  My plugs are not cauterized, could do that to seal them in for sure.  I could also plug that upper one again.  Are all four of your ducts plugged?

I do not think your lotion caused any of it.  It sounds like you're in a flare.  I'd like to talk more about your IC and how you deal with it.  My doc. is ordering IVIG for the SNF neuropathy and this should suppress immune system down and help all my problems.  I hope (fingers crossed), but this disease leaves one always wondering  ??? the best way to handle stuff.

I'm also neg. on antibodies, but have pos. lip biopsy.
Karin
« Last Edit: October 24, 2009, 06:01:33 PM by hoping »

eyeamdry

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Re: punctual occlusion 2 years ago
« Reply #5 on: October 24, 2009, 06:21:06 PM »
Your eyes may "flare" for any number of reasons.  Being comfortable for awhile after plugging, cauterization etc is no guarantee you'll always be that way.  Sometimes you have to start all over.

I'd want to make sure the plugs are still there.  You can also start the old routine of warm compresses, lid scrubs and massaging your eyelids to get the oils flowing.  It might not take long to get you feeling better again.   ;D  Lucy

Bigmama

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Re: punctual occlusion 2 years ago
« Reply #6 on: October 24, 2009, 09:21:21 PM »
Someone might have stated this but, the occlusions might have re-opened.  I have had mine done three times over the past few years.

Also, I started a new round of vitamins to help and "think" I am producing some tear like film (I have no tears).

Bigmama

louisa

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Re: punctual occlusion 2 years ago
« Reply #7 on: October 25, 2009, 07:36:20 AM »
Thanks for your replies. As i said in my posts, my plugs are still in place. I am sorry for for the lady (hoping) who has been diagnosed with interstitial cystitis. I dont know if you are in the uk but my local hospital offers cystistat treatment on a weekly basis and then monthly. I think this is what has helped settle mine down, its a chemical solution that lines the bladder on a temporary basis. Dont get too down, i think this will get better for you, it does fluctuate but over the years i am not in as much pain as it was when it started. I must admit i probably will not post here again as some of the posts do get me down and i am feeling quite depressed and need positivity however bleak the situation.I know nothing is a guarantee and i should know not to focus on the really bad cases.
If you want to email me you are welcome to.
Louisa

hoping

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Re: punctual occlusion 2 years ago
« Reply #8 on: November 01, 2009, 10:24:50 AM »
Have had the bladder washings with chemical into bladder four times, it has not helped.  See the urologist for follow up this week.  Must get my Sjogren's under control with heavy duty aggressive treatment.  Dr. Birnbaum is working with me and local docs who are so slow.

Glad to hear it does settle down.  I've had to have ice pack between legs for much of day.  Some of it may be sm.fiber neuropathy.  Though urologist said I had severe IS.

Sigh... Karin

Patze

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Re: punctual occlusion 2 years ago
« Reply #9 on: November 01, 2009, 01:25:40 PM »
Hi Louisa,

I too have both lower lids plugged, and I was hoping that it would bring some relief to my eyes, it didn't.  I was never able to stop with the lid scrubs, the daily compresses, and the Restasis (along with the constant use of regular eye drops).  I need to get the upper left eye plugged as the right eye is not nearly as dry.

I'm sorry that I can't speak of interstitial cystitis, but I sure hope that your doctor can get a good handle on it soon.

Take care and hang in there -

Patze
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Scottietottie

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Re: punctual occlusion 2 years ago
« Reply #10 on: November 01, 2009, 08:26:49 PM »
I think in the UK Restasis is called cyclosporine (but I could be wrong) I don't know how widely used it is.
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TurkishTutor

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Re: punctual occlusion 2 years ago
« Reply #11 on: November 02, 2009, 12:38:55 PM »
Hi Louisa

(from Edinburgh?) I am in the UK too. Had upper and lower plugs done in one eye about 2 years ago whilst in New Zealand. Made things a lot better most of the time, but one popped out a couple of months ago. Eye doc here in Ripon (N Yorkshire) put two in my other eye at my request, and within about 3 weeks they both disappeared! He did it again and they are fine. I think 'staying power' can also depend on getting the correct size - after a horrendous experience the first time in NZ I insisted on having my puncta measured to get the right size plug as the eye doc had tried to force in the large size.  If I get the odd dry day I check my plugs are still there by looking sideways, and then I can feel the plugs.

Here in the UK the eye doc tells me they don't measure as all such instruments have to be disposable and I guess it does not fall within NHS budgets. However, on my second trip to him he put slightly larger ones in and so far they are ok. It puzzled me how I 'lost' the first two he did - I think it must have been by rubbing my eyes in my sleep.

Sometimes I get an unbearable itch and want to rub the inner corners of my eye but have to restrain myself an instead press a cool damp compress on until the itch has gone.

Just a note to those in the UK - as you know we have to be referred to the eye doc by our GP but since this happened I just call the eye doc's secretary direct saying I have a problem, and always get to see him within a day or two.

Tabby


Patze

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Re: punctual occlusion 2 years ago
« Reply #12 on: November 02, 2009, 08:16:26 PM »
Hi Tabby,

I've heard others mention that their plugs have come out, but mine are in there pretty tight (so far - crossing my fingers here! ;)).

When I had mine put in, the opthamalogist tried to find the correct size and stuck the tool a size too large in and pulled it out very quickly, and I about came out of that chair it hurt so bad (thankfully most doctors work from a smaller to larger size, not the other way around).  One went in all the way, and the other one has been only seated halfway in, and she couldn't get it in any further, ugh.

When my eyes are dryer than normal, I sure do feel them and like you, the itching can get to maniac proportions, maddening, but so far still have them in.

Take care -

Patze
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trector1955

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Re: punctual occlusion 2 years ago
« Reply #13 on: November 02, 2009, 09:05:05 PM »
Hello,
    I have had all 4 of my tear ducks cauterized. I sometimes have tears running down my face. always have a tissue with me to wipe away the tears. My eyes don't burn like they did. People look at me like I am crazy when I tell them I have severely dry eyes when there is tears running down my cheeks LOL. I don't have to use eye drops like I use too. I do use Restatis.  I am very glade I did this cuz the dryness and pain was terrible. I still have problems not being able to see real good. But at least they don't burn.
Theresa

wandar

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Re: punctual occlusion 2 years ago
« Reply #14 on: November 12, 2009, 10:29:25 PM »
I too have plugs in my lower lids of both eyes. I live in the states and instead of silicone plugs, which it sounds like most of you have, I have a material called medennium. My opthalmologist is my boss and he is the one who diagnosed me with severe dry eye ( my schirmers test was 0 for both eye which is as dry as you can get). We use meddenium plugs when we don't want to "play around" with someone's dry eyes. They arrive frozen and have to be quickly inserted as the material melt s with the pts body temperature as they are inserted.  The result is a gummy sticky wad that basically doesn't change size. They are inserted into the drainage canal rather then just at the opening(the nasal lacrimal duct also called the punctum, hence punctal plugs) and once in place are VERY difficult to budge or lose. Sigh, even so I still have bad dry eye. I'm also on restasis and used gel tears. Many days my eyes feel ok,  but some days they are intolerable. I'm considering getting medennium in the uppers as well but I've been so busy at work working up pts to be a patient myself. Haha. Isn't that awful? As to the cauterization, my office has has experience with a few pts having the punctums spontaneously regenerate a new hole. Freaky but true.