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migrated silicone plugs - how they going to get it out ?

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  • migrated silicone plugs - how they going to get it out ?

    My lower left silicone plug has migrated..can no longer be seen without close inspection (by an optometrist) ..

    The eye is now bone dry and even if drops are put in they are gone in a couple of minutes....seems its not doing much blocking.

    Note the left eye has left upper cauterized as well.

    My BIG question is..how do they get the plug out !!!!! ???


    The Ophthal who put it in..as it went in easy..he said it was the largest size they do...lies lies lies...??
    He could not be bothered to find a bigger size ??
    Whatever the reason I think it's almost malpractice to not discuss this with me..and tell me the problems that may occur from installing a plug that is to small for the duct !

    The thing is I have a large lower duct....so perhaps a candidate for a smart plug.... !?

    Thanks in advance for any help with this...I would like to be clued up before I see the Ophthal...

  • #2
    Originally posted by why View Post
    The Ophthal who put it in..as it went in easy..he said it was the largest size they do...lies lies lies...??
    He could not be bothered to find a bigger size ??
    Besides the fact that you say its migrating now, what makes you say that it was too small? Do you have any comparison as to what "going in easy" is vs one that doesn't? How big of a plug was/is it? Did you ask the size?

    bassfan

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    • #3
      There are gauge sets readilly available from at least three plug manufacturers that will allow an eye care provider to know exactly which size plug to use. If your puncta is larger than the .8mm size then you are a candidate for one particular intracanlicular plug.
      If your eye care provider can see the plug then technically it should still be occluding the puncta. if he can see it he might try a needle piercing the silicone and then "shoe horning" it out. Or using a jewelers forceps to grasp it and pull it straight out. Irrigation would be last resort.
      Hope this helps.

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      • #4
        Originally posted by bassfan View Post
        Besides the fact that you say its migrating now, what makes you say that it was too small? Do you have any comparison as to what "going in easy" is vs one that doesn't? How big of a plug was/is it? Did you ask the size?
        bassfan
        Hi bassfan
        Thx for replying
        I say it was too small because it went in so easy..and almost the next day was descending into the tear duct.
        I compare it to the right eye that had to be bored out to accept the plug.

        The plug was an Eagle..the biggest size...however ive since found out that their are many manufacturers and types of plugs..including larger silicone plugs !

        The Ophthal never guaged/measured the size of the duct..he just installed the largest plug they had.
        I asked him at the time if he could get a larger size..he said no thats all the largest size u can get...I trusted him


        Hope newbies looking at getting plugs learn from my experience...

        If Id found this site before plugs and read up on the different types i wouldnt be having this issue now.

        Comment


        • #5
          Originally posted by indrep View Post
          There are gauge sets readilly available from at least three plug manufacturers that will allow an eye care provider to know exactly which size plug to use. If your puncta is larger than the .8mm size then you are a candidate for one particular intracanlicular plug.
          If your eye care provider can see the plug then technically it should still be occluding the puncta. if he can see it he might try a needle piercing the silicone and then "shoe horning" it out. Or using a jewelers forceps to grasp it and pull it straight out. Irrigation would be last resort.
          Hope this helps.

          Thx so much for the info "indrep" it was veery helpful and is much appreciated...

          One would have hoped the Ophthal should have been providing this info...newbies beware.

          Thanks again...see a new Ophthal on Monday to explore options on removal and replacement..

          Although the the plug is deep..and still in the duct...Im not sure if it is blocking as my left eye is soooo dry now.

          I guess it could be just getting worse....arghhhhhh !

          Lets hope they can make something that stimulates tear flow..perhaps electrically sooon.

          Comment


          • #6
            I had one of my lower plugs go into the tear duct canal and now it is nowhere to be found. I tried putting nutra tear drops in eye and the drops flow down through my left nostril. I guess its not plugged anymore. Trying to get it replaced. It is an inconvenient situation. He could probably just pop a new one in and leave the other alone if its not causing any trougle.
            Take care, dnew

            Comment


            • #7
              Originally posted by dnew85 View Post
              I had one of my lower plugs go into the tear duct canal and now it is nowhere to be found. I tried putting nutra tear drops in eye and the drops flow down through my left nostril. I guess its not plugged anymore. Trying to get it replaced. It is an inconvenient situation. He could probably just pop a new one in and leave the other alone if its not causing any trougle.
              Take care, dnew
              thx dnew for your reply...yeah it is very inconvenient when one eye is so out of balance with the other.

              Im not sure if he would put another one in while the other is still in there as perhaps the situation would increase the risk of infection... I dont know

              Wishing you a speedy return to balance !

              Comment


              • #8
                Ive got a couple of threads going..but I think I needed to tie thise one up as well.

                Back from the Ophthal...he does not want to get the plug out..he says it's still occluding (I dont think it is )..

                However this leaves me now with eyes that are unbalanced one bone dry the other with some moisture.
                It's frustrating and im sure many with these problems know it makes everything you do a struggle..

                I now walk around with preserve free drops ..dropping everywhere..cinema..supermarket...u name it every ten minutes I have to stop tip head and drop just to get by.

                Ive seen 6 Ophthals at last count and each brush me off saying they cant do anything.. sorry just have to vent a bit

                i am coping just need some hope rather than not...Ive asked Dr Lange if Electro stimulation of the lacrimal gland may work..me being an electrical engineer i could make something that could activate the lacrimal nerve..await to see what the Doc says...

                Gotta be more good treatments soon.

                Thx for listening
                All the best to all

                Comment


                • #9
                  Even with plugs it can be hard to find that balance. I have one eye that sloshes over whenever the reflex tears hit, which is many times a day, and the other eye which remains bone dry. I know this is frustrating.
                  Every day with DES is like a box of chocolates...You never know what you're going to get.

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                  • #10
                    Kitty so true isnt it frustrating !...lets hope a treatment comes along soon that can make a real difference for us.

                    Comment


                    • #11
                      Why,

                      Just because it is not visible doesn't mean that it has migrated. The one in my left eye seems to just fall out on a regular basis or migrate directly to my lungs (?? just joking)

                      I was concerned the first time it happened that i insisted that the DR irrigate the puncta just to give me piece of mind. Sure enough, it wasn't still there.

                      I guess the difficulty I then had was accepting whether it had actually fallen out or had migrated to the back of my throat and was gone for good.

                      Either way I was happy it was no longer lodged in my puncta.

                      It is a tough road, with lots of bends and deadends, however it does get better, just keep your focus on getting through this, it will get easier to deal with.

                      Cheers

                      Ian

                      Comment


                      • #12
                        At one point along this long path, I had an Oasis intercanula plug put in my right eye. It seems to be working for about 3 months. I had plenty of tears. Then all the sudden I became bone dry. I went back in and she couldn't see the plug any more. She put another oasis plug in and this time, it didn't help me one bit. She then put a regular plug in next, one with a visible cap on the outside, not an internal one, and it fell out. We tried several until we finally found one that stayed in. I also have huge puctums and that is a big part of the problem, finding plugs large enough to fit. The intercanula plugs only puff up so large. So I may have 2 oasis plugs floating in there but probably not. She told me that I probably just swallowed them. We finally found a large enough plug that works and has stayed in.

                        You were ok at first with the internal plug and now you're not. You're not imagining that. (Um, no "Dr" it is not still occluding )That means it's not there, or you've swallowed it, or your punctums are really big and the plug is just too small. It may still be in there and it may not. The most important point is that you are dry as a bone. You need to put another plug in that punctum but choose one that has a cap so you can always see it. It totally sucks that you have seen so many doctors who either don't care or are just not that up on plugs and dry eyes.

                        Keep pushing until you find a doctor that will put another plug in. As long as it is big enough and it is the kind that have a cap on them, what's the harm? You need comfort. Move on to the next doctor.

                        Good luck, I really feel for you.

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