Scleral question: eye waters but does not drain; will Scleral lens work?

[Hokiegal]

Hi! I've been reading through the postings on Scleral lenses, and it seems they work well for dry eye.  However my case is slightly different.  After almost a year of dry eye and lacrilube, my eye started to make tears again, intermittently, but enough so that I rarely need to use drops.  The problem now is that the tears do not drain.  They pool up in my eye, causing blurry vision.  The way it was explained to me, there is a muscle near the eye that sends tears in, and another that drains them back out. Both are controlled by branches of the facial nerve.  In my case, the first branch regenerated, but the second branch did not.  So I am wondering how the Scleral will work in my case.   After some research, I have found two providers reasonably close, and they both say I am a viable candidate based on our phone discussion.  However, neither seems familiar with AN, and neither can explain how a Scleral (or any other specialty lens) will solve the issue of tears pooling up.  Has anyone else been in this situation?  The two providers I am considering are in Greenville, SC, and Columbia, SC.  Any comments or advice would be truly appreciated! 

Mary

[saralynn143]

Interesting questions. Those of us who wear sclerals wear them specifically for dry eye. The lens is designed to maintain a fluid reservoir on the eye, so I do not see how the lens would be able to do anything about pooled tears. That would be a separate issue that an eye doctor might be able to help with. It's possible that your eye's drainage system is somehow blocked.

I can tell you that shortly after surgery I would get a lot of tear build up, and I would tilt my head and pull out my lower lid slightly to drain them out. But after a while it stopped. Now my eye tears when I cry, exercise or eat spicy food and that's about it.

[jazzfunkanne]

what about the plugs you can get too help drainage has anyone used them x

[saralynn143]

I think that plugs would be counterproductive in this case because they are designed to keep tears in the eyes instead of draining.

[Hokiegal]

Thanks for the replies!  I made an appointment to see one of the specialists in a couple weeks.  I suppose I have nothing to lose aside from the cost of the visit.  I'm hoping it's simply a plugged duct.  If it's not, and they recommend the Scleral, I'll definitely insist on an explanation of how exactly it's supposed to work in my case. 

[saralynn143]

I have a theory about why a scleral might help. Maybe when your eye stops feeling dry due to the fluid reservoir provided by a scleral lens, it will stop overcompensating with extra tears. Just a thought.

[Hokiegal]

Hi everyone, just wanted to give you an update on my overly watery eye!  Long story short, I ended up asking my neurologist about this.  After I explained to him what a scleral lens is (I felt so smart!  ), he was doubtful it would help in my case.  But as I was walking out the door, he did offer a theory  -- that perhaps my eyelid is not blinking enough, so my eye thinks it is still dry, and that's what's causing the excess tears.  He referred me to a neuro-opthomologist (N-O for short).  Dr. N-O studied my eye for a LONG time, and came to the same conclusion.  He also observed that my eyelid is not actually closing all the way on casual blinking -- all this time, we thought it was.  And Dr. N-O observed some dryness of the cornea, which really surprised me because I don't feel it.  Root cause of the waterfall-- localized dryness due to inadequate blinking.  So Saralynn got it right!!!  He recommended an outpatient surgical procedure to lift the lower lid ever so slightly, making it easier for my upper lid to fully close, and fully distribute those tears.  I'll start another thread on this in case it is helpful to others, but I wanted to thank you all for your comments and let you know what happened.  Now, what do you think my chances are for getting insurance approval to have the procedure done on both sides?  Seems like it would erase a few crows feet as well 

[saralynn143]

Ha! I love being right.

I hope the procedure helps. My eye only blinks about halfway, so I don't think it would work for me.

Thanks for sharing. It's great to have info about all of these options available.