Having problems with tear duct!

[Sleepygal1]

Hi All,

I'm experiencing a red, inflamed, puffy side of the eye and below where it meets the nose. Looking online it seems to match up with tear duct inflammation. I've had it a few months before but it went away fairly quickly. This time I woke up and instead of going away the eye was all puffy as well as red. I'm thinking this is due to the cpap mask as I've also been having problems lately with my sinuses.

My CPAP is at 12cmH2O. I can't lower it without significantly increasing my AHI. I've already gone from an AHI of 0.5 at 12.5 to 1.5 at 12. I've tried setting it to auto mode with a lower minimum but the changing in pressure all night drive me crazy and don't seem to control my AHI well enough.

I already use a heated tube and humidifier so I don't know that I can change anything else there.

I think it may be what this describes as "Nasolacrimal Air Regurgitation" causing my issues and thinking I may try a total face mask like they recommend here:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6086962/

The only model I can find is called the FitLife: https://www.cpap.com/productpage/respir ... k-headgear

Does this seem like a good idea? Will it cause other issues with the pressure on my entire face instead?

I also just found out there's some sort of goggles to protect the eyes. One is called "Quartz silicone shield". Have not looked into this but would that be a good option to equalize the pressure or even some sort of swimming goggles? I'm already taping my mouth with a dreamstation nasal mask so what is one more crazy sleep device!

Any help appreciated!

[Pugsy]

The FitLife mask won't cause pressure issues on your face in general. Most likely won't even notice the pressure it is so diffused.
Might be worth trying but let me warn you...it's a bitch to seal and keep sealed. I tried one once just for grins to see what it felt like and the pressure was a non issue but the leaking was awful. I never could get it to seal and stay sealed for longer than about 15 seconds...never made it to actually sleeping with it. People do use it successfully though and to those people I bow down in awe.

I don't know if the goggles would help if the air is going up the duct from the nasal passage and irritating the eye that way.
There are ducts inside the nasal passageway that go up to the eyes. Normally these ducts are closed off so the air pressure can't go upwards but in some people they are open and that creates a problem. If your ducts are open...the goggles won't close them off.

You really should be seeing a real eye doctor and have those ducts evaluated. Make sure exactly what is going on and figure out options.

[Sleepygal1]

Thanks so much Pugsy for your reply.

I figured the mask was cheaper and quicker than finding a real doctor in these parts

Do you know if a Sinus CT scan would show those sorts of issues? I went to an ENT when the sinus issues began and next step was to go to the CT. I put it off because the sinus issue got a bit better randomly and I didn't want the X-Ray dose if it wasn't absolutely necessary. I've already had thyroid issues so the thought of xrays pounding my thyroid didn't seem like a good idea unless it was an emergency.

If not, I guess it's on to the next doctor. I'm assuming Ophthalmologist is the right one to see? Does that sound right?

[Pugsy]

Yes, opthamologist is the right one.
Not optometrist...
I do not know how detailed a CT scan might be and I do not know if it would include the ducts anyway. Depends on where they target for the scan. These ducts are teeny tiny ducts...not easily seen I would think but it's been a long time since I have seen any CT scan details so maybe it is better now. MRI might be even better.

Don't worry about x ray doses so much now. They get so much detail with minimal exposure now that it really is a non issue.
Used to be that CT scans took hours with many many exposures and now they can get it done in 10 minutes with minimal exposure.

The mask would be cheaper and faster experiment though...worth at least trying but don't dally too long. God gave us only one pair of eyes and it's up to us to make sure we don't screw them up waiting to long to take care of them.

[chunkyfrog]

+1,000 to Pugsy.
Get thee to an ophthalmologist.
Could be an infection in/near the tear duct.
Easily treated--really nasty if you wait.

[Sleepygal1]

Thanks again!

Opthalmologist appt this afternoon. Hoping it's not something serious! Unfortunate thing is it's always 1 step forward 5 steps back with everything medical... *grumble*

Also have a fitting for the full welder mask CPAP mask tomorrow AM. So, hopefully it'll work for me. It'd be amazing if i can handle it since I could stop taping. Not that hopeful though as nothing ever fits my face properly. I already have a full face dreamwear that leaked like the dickens, so I assume this thing will be even worse.

[Pugsy]

Glad to hear you are getting it checked out.
I am paying for dallying with something that had to do with a tooth. I of course now which I hadn't dallied but it's too late now and I have 2 options in front of me and both are ugly options. Damn. Don't even take a chance on screwing up your eyes...they are much harder to replace than a tooth.

[Gryphon]

Seeing an eye specialist is a good idea as already recommended. With all the redness and inflammation, you don't want an infection to get going or worse get stuck in that duct and cause complications.



I will say I've had first hand experiences in varying pressure ranges with air or tears being blown back into my eyes from the ducts that discharge into the nose from the eyes... it's a bit weird, I've had this problem persistently for ages then it sort of went away.

Now, I still have some nights were I know my eyes will tear up like the tears that were already in the duct are being forced back into my eyes... but once the duct is empty I don't get any air leaking like it must seal shut naturally. I usually feel this happen with in a few minuets of putting on my mask and the air kicking in. I worked out that I most likely didn't have a constant problem with air leak as I've woken up a few times later in the night and could feel my machine was really pushing it so I glanced over and saw the pressure range was like 22+ I didn't have any air blowing in the eyes at that time through the ducts, but that's just "ME"

I'm thinking it's more like people who swallow air... a big problem for some, but mostly not an issue and it's all on a curve depending on your own circumstances.

Lots of "Your Mileage may Vary" issues here.

Hope your able to clear up your eyes soon and that your able to find out some useful info from the doctor.

Restwell,

Gryphon