Question: Following removal of a basal cell carcinoma on myleft inside corner of eyelid and the medial canthus in Aug. 2011, which involved Mohs surgery and sacrificing the tear ducts in left eye, I have been suffering constantly with continuous mucous strings that accumulate in left eye. Sometimes I can remove them after a few attempts, but another one forms soon and sometimes I go for days without being able to remove the mucous string. My eye tears a lot as a result. As a result the vision in that eye is worse due to the 'glob' of 'gunk' that is in there. I am frustrated that neither my opthmalic plastic surgeon or my regular opthmalogist can find some drops that can help dissolve those mucous strings. It is very uncomfortable and I have to constantly keep a Kleenex handy for the excess tearing and also try to get the mucous string out. My eye stays red most of time, likely inflamed making it worse.
Any ideas? My doctor first Rx'd Pantanol, but it is $125 and can't afford it. Same for Lastacaft. I use the preservative free vials of moisture lubricant drops but the don't help the mucous. Please help. I have an appt. soon with opthmalogist, he has not treated this before and is on a 'fishing expedition' trying to see what will work. The Lastacaft free sample helped minimally. I am apprehensive about trying Restasis due to negative reviews I have read, and it is also very expensive, $300 and it may not work either.
Thanks so much for any suggestions.
XXXX

Dear Dr. Misra,
Thank you for your kind reply and suggestions. I saw my opthmalogist today (before reading your repy) and he Rx'd a mild steroid drops, Flouromethalone, .1%, one drop left eye 2x day. He felt this would help 'settle down the inflammation' and get me some relief asap, since I have been miserable with this. He will monitor this closely since there are possible side effects and does not want the eye pressure to increase or worsen my small cataract that has formed. Sorry, forgot to mention that he found a small cataract as well.
When I see him for followup in 2 wk, I will ask him about Rx'g a/biotic drops as well. Do you foresee any contraindication with using a/biotic drops as well as the steroid drops during same day? I know I would need to wait 5-10 minutes in between the two meds.
My opthmalogist -plastic surgeon did initially insert a very narrow plastic tube like a monofilament line during surgery to help form a new tear duct/channel. Unfortunately, it began to work it's way out and was very uncomfortable, so he removed it, this was only 3 wks after the initial surgery. He felt it should have been successful in forming a new channel for tear drainage had it stayed in for 5-6 wks, but he saw no choice but to remove it due to the discomfort. He said there was a possibility that a new tear duct/channel had formed, even partially, in those 3 wks. Tears are no longer 'spilling' out of my eyes, but do accumulate somewhat. It's he mucous strings (they are about 1-2" long) that irritate me and are so uncomfortable. I can live with a few extra tears however.
I did discuss an alternative for drainage with the opthmalic plastic surgeon last year; he advised that he could perform a ('brutal') surgery inserting a pyrex tube for drainage, going up through the nose, etc. But said it was 50/50% that I could tolerate it, many do not and have to have it re-inserted or just removed. I did not want to risk going through surgery again if the tube was unsuccessful. He said if he were me, he would just live with it.
Thank you for any comments/suggestions, Dr. Misra.
Sincerely,
XXXX