The procedure was completely painless & took about four minutes per eye to insert them, if that. The doctor was going to numb the duct areas with a topical anesthetic but I asked her not to, as I didn't think I'd have a problem without it. Sure enough, it was just a few moments of sensing a slight prodding with a tiny instrument into the tear ducts, she shot & released the little plugs into the ducts, & presto! It was done. So I would encourage others to try to have it done without an anesthetic. If I had gotten it, it would have worn off quickly, but I really didn't want to tolerate an hour or so of having the sensation of numb lower eyelids!
This blog is to document my experience with tear duct plugs & hope it can benefit others who may not be aware of this remedy for Dry Eye Syndrome, or may help others consider getting tear duct plugs for themselves.
Punctal Occlusion (tear drainage duct occlusion) is a procedure that eye doctors use to improve the symptoms of Dry Eye Syndrome (inserting punctal plugs (silicone or collagen) into the tear drainage area of the eye to keep the tears in the eyes longer. I had silicone plugs inserted today.
Dry Eye Syndrome ("Keratoconjunctivitis sicca")
This is a medical condition where the eye surface & tear-producing glands (lacrimal glands) are chronically inflamed due to insufficient tear production. It is a complex condition & can also cause neurotrophic deficiency & meibomian gland dysfunction.
As people age, from age 40 & older, develop this condition which is quite common. In fact, after age 59, prelevence of this condition more than doubles!
Those age 89 & older -- both sexes experience Dry Eye Syndrome more than any other age.
It can also occur when one uses the computer a lot or does a lot of reading. Some medical conditions, certain medications & environmental factors can cause Dry Eye Syndrome.
As many as 40 million people in America suffer from this condition. Postmenopausal women may be the most susceptible due to decreases in hormone levels that can lead to loss of antiinflammatory protection and decreased lacrimal function.
People with other inflammatory conditions -- particularly allergies, asthma, & collagen vascular disease are also at risk.
People who've had eye surgery can have it.
Those who suffer with Dry Eye Syndrome are at risk to develop infections that could blind you -- such as bacterial keratitis, & these patients have higher risks when they undergo procedures, such as LASIK.
Bacterial keratitis is costly & can lead to corneal transplants — a $20,000 procedure!! Indirect costs of this bacterial condition can result in permanent scarring. Without a corneal transplant, these patients can experience impairment in driving at night, engaging in certain activities and it can affect their work performance. It can affect the quality of one's life!
Dry Eye Syndrome can also indicate other health conditions. The doctor should should always refer a patient with Dry Eye Syndrome to an ophthalmologist.
When inside an airplane, living in a dry climate, being enclosed in heated or air conditioned rooms, these situations can cause some patients (ike me!) must apply artificial tears several times every hour, with little lasting relief exacerbated by protracted blurred vision.
Those at Highest Risk for developing Dry Eye Syndrome include those with the following conditions:
• Inflammatory diseases (vascular, allergy, asthma)
• Autoimmune diseases (RA, lupus, colitis)
• Peri- and post- menopausal women and Hormone Replacement Therapy patients
• Diabetes mellitus
• Thyroid disease
• Sjögren’s syndrome
• Corneal transplants
• Previous keratitis or corneal scarring
• Extracapsular or intracapsular large-incision cataract surgery
• Laser in situ keratomileusis (LASIK)
• Systemic medications (diuretics, antihistamines, psychotropics, cholesterol-lowering drugs
• Contact lens wear
• Environmental conditions (allergens, cigarette smoke, wind,dry climate, air travel, chemicals, some perfumes)
Caffeine was surprisingly found to have a protective effect in a research study (didn't help me, though!).
Here is a great paper on Dry Eye Syndrome:
http://www.ptcommunity.com/ptdigest/0312_ptd_dryeye/0312.ptd_dryeye_mc.pdf
Dry Eye Syndrome affects worker productivity. Personally I find this to be true, when I have to stop every hour or more to insert artificial tears or eye drops into my eyes, & it makes for reading small print & reading print on a computer monitor more difficult as I get blurred vision, eye fatigue, etc.
It also affects one's appearance. By mid-morning, my eyes appear bloodshot which makes you look tired, & people think you aren't getting enough sleep. By the end of the day, my eyes are completely shot & I look like someone that was an actor in a Zombie movie!!!
Treatments for Dry Eye Syndrome
First my eye doctor had me using artificial tears & after about 8 months, it wasn't helping & I was using it more and more - 6 - 10 times a day or more!
Then my eye doctor had me purchase a new over-the-counter eyedrop for dry eyes -- "Systane Balance" the "Restorative Formula" brand. These are lubricant eyedrops of clinical strength & provide intensive therapy for dry eyes, and are made by Alcon. I purchased a 1/3 ounce bottle. The active ingredient is Propylene Glycol, which is a lubricant.
These eyedrops are fantastic, & help a lot better than the artificial tears. I have a friend my age who also suffers from Dry Eye Syndrome, & her doctor first prescribed these same eyedrops & they have solved her problem.
Unfortunately, using them was not enough. I was still needing something more.
Research has determined that Dry Eye Syndrome is a systemic disease &
that it responds well to cyclosporine anti-inflammatory therapy.
Rather than get an expensive prescription for Restasis, a new prescription that treats Dry Eye Syndrome (and has some possible side effects), the tear duct plugs were cheaper & are a drug-free solution to this condition.
I will post in this blog in the future - a week, two weeks, a month, etc. to report to my readers progress I experience with the tear duct plugs.
Acupuncture
One study was done in December, 2010 where they found after treating patients four times a week with acupuncture, that it effectively relieved the symptoms of dry eye & increased watery secretion in the eyes.
I would think it would be inconvenient & expensive to have to get four acupuncture treatments a week to get results, & don't know if it would provide long or short term relief.
Symptoms
Dry Eye Syndrome gives one a feeling of discomfort in one's eyes which generally worsens as the day progresses. You might have a sensation of burning, itching, feeling your eyes are gritty, irritated, have blurring of vision, red eyes, or other ocular symptoms.
You must treat Dry Eye Syndrome because it won't just go away by itself.
How Tear Duct Plugs Work
The human tear film consists of 3 layers: lipid, aqueous, & mucous -- which are produced from different parts of the eye.
The aqueous layer is produced by the glands of Krause & Wolfring & by the lacrimal gland, all located in the superior eyelids. The lipid layer located is located farthest from the eye & is produced by the meibomian glands. It functions to slow the evaporation of the underlying tear layers. The mucin layer of the tears located directly on the cornea is produced by the goblet cells of the conjunctiva.
The tears coat & lubricate the eyes & then exit through the eye’s drainage system. The tears flow into the drainage holes, called lacrimal punctum, which are located in the inner corners of both the superior & inferior eyelids. From the punctum the tears flow through to the drainage tubes, called the canalicula & then to the lacrimal sac & then the nasolacrimal duct, & finally exit into the nose & to the back of the throat. (Thats why your nose runs when you cry!)
For more information about the plugs and other eye conditions, visit this website:
http://www.mastereyeassociates.com/eye-diseases-treatments/punctal-occlusion
No comments:
Post a Comment