plugs for MGD

[Anthony16]

Hi there,
i was just wondering if it is an accepted fact as to whether or not plugs are effective for patients with MGD(a quality rather than quantity problem)
I have accutane induced dry eye(moderate severity according to several docs) and was wondering if they are worth the cost,for a patient with MGD?
i know another couple of people with accutane induced dry eye who say plugs have helped them a good bit.Would these people likely have aqueous component also?
thanks
Anthony

[spmcc]

Re: plugs

I have had plugs in the lower puncta, the upper puncta, and all 4 puncta. I've had cellulose (dissolvable), silicone, and intracanalicular plugs. I've also had cautery 3 times.

As for me, I say that if you don't know how plugs will affect you, start with dissolvable plugs. I tried the 10-day plugs, but found that too short to even test their benefit (it can take a 2-4 days to kick in). So I prefer the 3-month dissolvables.

Best thing about those plugs is they're not a permanent change/commitment.

[Anthony16]

I have had plugs in the lower puncta, the upper puncta, and all 4 puncta. I've had cellulose (dissolvable), silicone, and intracanalicular plugs. I've also had cautery 3 times.

As for me, I say that if you don't know how plugs will affect you, start with dissolvable plugs. I tried the 10-day plugs, but found that too short to even test their benefit (it can take a 2-4 days to kick in). So I prefer the 3-month dissolvables.

Best thing about those plugs is they're not a permanent change/commitment.

Thanks.
Its hard to know whether i should try plugs and (possibly) waste a lot of money or try and wait this thing out.2-4 years is the general timeframe iv been given but not sure if i can go that long
Oh well,im sure ill decide soon.
Cheers

[irish eyes]

Unsure what to say Anthony.

Years ago I had the lower puncta plugged but the doctor didn't think they were doing much good - so I agreed to having the top done as well. (Not the permanent method).

It was dreadful in my case; my eyes were certainly wetter but it was like a quagmire. I developed cysts along the top and bottom eyelids and seemed to be in the emergency clinic for weeks. Bacteria gathered in and around both eyes and there was no passage for it to escape.

After a few months, one of the bottom plugs fell out so the doctor decided to remove the other. I had been on doxycyline for a good length of time before this but I seem to have problems generally coping with infection / inflammation.

I now have just the top ones plugged - apparently they preserve around 30% of tears that you might lose when `reclining'. They seem to get red around the edges from time to time but the consultant thinks they are probably of some benefit.

MGD is one of my problems.

[indrep]

Anthony,
The DEWS Report published in April 2007 Acknowledges that dry eye disease is "accompanied by increased osmolarity of the tear film". Increased osmolarity of the tear film is what initiates the inflammatory mediators. You will never remove the "junk" in the tear film until you have more water on the ocular surface to lower the osmolarity of the tear film. It is unfortunate a company promotes this "junk in the tear film" to promote their product. It misleads many eye care providers and patients.

[Anthony16]

Anthony,
The DEWS Report published in April 2007 Acknowledges that dry eye disease is "accompanied by increased osmolarity of the tear film". Increased osmolarity of the tear film is what initiates the inflammatory mediators. You will never remove the "junk" in the tear film until you have more water on the ocular surface to lower the osmolarity of the tear film. It is unfortunate a company promotes this "junk in the tear film" to promote their product. It misleads many eye care providers and patients.

Ok thanks again everyone for your help.Ill see in the next couple of months whether or not to ask my doc to let me try temporary ones.I think the big problem for accutane patients is that we simply dont produce enough oil rather than our glands being clogged or whatever.Thats the vibe iv gotten from a lot of docs and thats probably why there are no real treatments available to us.
Thanks guys