Enlarged puncta

[anonymous_825]

I have been having eye issues for a year or so.  I've seen my eye doctor and he's done all kinds of tests and rechecked.  I was having a problem with the quality of my tears and tears overflowing, mostly on my top lids, which caused really irritated skin, which made my eyes tear more...a vicious cycle. Some of the old glands were also clogged.

I'm using lubricating, balancing drops and allergy eye drops and keeping the eyelids moisturized.  I'm still having intermittent issues.

The thing is, the puncta on my left eye (I have 10x more problems with this eye) is enlarged.  It is has a visibly bigger opening compared to the right.

I've tried to do compresses and massage.  I have no discharge or pain, just irritation.

Do puncta change size?  Anything else I can do?

Why do my tears go to my upper lid, or at least just cause so much more irritation there?

I try to follow a good routine but do wear makeup to cover dark circles, but have done that for years without having any problem.

Any suggestions are appreciated!

[anonymous_825]

Bump.  Anyone have any insight?  Thanks!

[anonymous_825]

Don't know if this info has value here, but I have a raised ANA, no sjorgens (thought to check first b/c of eye issues), no cause determined yet.

I have low b12 and vit d, both of which I supplement.