I went for it....

[kitty]

Today, I got my two lowers plugged with the Herrick intracanalicular silicone plugs. This time was so much easier than the temporary collagens were. I felt nothing. This time my doc did it with me lying back in the chair, using his Loupes, rather than with me sitting at the slit lamp. I think it was more comfortable for both of us. I go back in two weeks for a re-check. The tech said at that time, they may give me some sort of drops to test the waters for having all four permanently plugged. Does anyone know what drops she might be talking about? I did not really care to ask at the time. The doc said that only about 5% of his patients end up with all four plugged. Delilah, if you are reading this, there is nothing to fear. My doc offered me the long-term dissolvable (6 months) in case I was not comfortable with having the silicone. Choices abound. Do what feels most comfortable to you. You will never know what will or won't help you if you don't try. I will check back with all of you in a few days and let you know what benefit I have from the lower plugs.

[Lucy]

Good Deal!

Kitty, thanks for your brief "report." It helps to let people know that plugs are usually nothing to fear. Good luck with them. Did they tell you it may take awhile for you to notice a difference?

[kitty]

No, they didn't really say anything Lucy. Thanks for the heads up. I shall be patient!

[indrep]

Plugs keep more tear on the eye so you will feel some relief soon, however, it takes several weeks for the osmalarity of the tear film to change. Lowering the osmallarity so the cornea can absorb the nutrients from the tear is essential to healthy corneas. Good luck and if you still need a tear the TheraTears(nonpreservative) are the only ones that have been clinically proven to increase goblet cell density and lower the osmalarity of tears.

[kitty]

Plugs keep more tear on the eye so you will feel some relief soon, however, it takes several weeks for the osmalarity of the tear film to change.

Is two weeks a sufficient time to determine benefit due to osmolarity? How long is several weeks? TheraTears in the vials is all I use during the day. Everything else either makes me itch or makes me feel more dry.

[indrep]

Using the Theratears in "saturation" dosing with plugs usaully takes about four weeks. Saturation dosing means using a drop of TheraTears every few seconds, without causing the tear to run out of the eye, untill the vial is empty. Depending on severity of the dry eye you may repeat this 4-8 times a day. After four weeks most people can use a drop or two as needed but at least four times a day. Remember you never "heal" Dry Eye Syndrome.

I would say that since other drops make your eyes feel dry, then you are already recieving the benefit of TheraTears.

[Gaye]

punctal plugs

Yesterday I had EagleVision SuperFlex punctal plugs put in my lower ducts. I am curious if anyone else has ever had these and how they feel about them. My eyes were very sore afterwards and are still sore today which suprised me as my first plugs didn't feel this bad. Interestingly, when I asked the doctor what kind they were, he answered "plastic plugs". Of course, that is not the answer I was looking for and told him I wanted to know what kind they actually were. He got so angry at me for not accepting his first answer that he dug in the garbage can and pulled out the package, tore the label off and handed it to me - never even explained anything about them to me. He was annoyed at me in the first place because he wanted to do cautery and I chose not to go that route just yet. Needless to say, I will not be going back to him again.

[kitty]

You deserve better than a dictatorship!

Sorry you had such a bad experience, Gaye. It appears to me like your doctor does not want to have you be an active participant in your treatment. You deserve better than a dictatorship! You are so right to seek treatment elsewhere. Do you have any itching with your plugs?

While my plugs are the Herrick's, I have had some soreness since they were inserted, especially in the right eye. That was the one that my doc tried to put too big a plug in. I have had some itching and can occasionally sense the plugs being there, especially if my eyes are really dry. I have also been having a bad flare of my DES, which tells me I probably need to have all four punctum plugged. I swear I was more comfortable with the 4 temporaries than I am with the two permanent ones! On the positive side, my Herrick's are the new blue ones, so I can see them through the skin! That is a good thing as I have occasionally questioned if one or the other was still there, especially after rubbing an itch!

[Gaye]

plugs

Hi Kitty, so far, my plugs don't itch, but they do hurt. My old ones felt great and they had been in for 3 years. But this new guy insisted that they were getting gummy and dirty and needed to be replaced. Sure hope he was right and that I made the right choice. I am always amazed by these doctors who think their treatment is 'top secret' and we are not on a 'need to know' basis. I constantly ask questions and expect answers. He was recommended to me as a dry eye specialist who had dry eyes himself. When I asked him questions about his own, he refused to answer me except to tell me that he used Restasis. So much for seeing someone who should really understand the problem! If they are not willing to talk to me and explain things, then I am out of there. I don't care how great a doctor is, if they treat me like a child who just needs to obey them, I will move on. My new plugs are very flat on top and white, so I can easily check them. I am sure that they should settle down in a few days. Blue would be kind of fun!

Previously I had one of my upper ducts plugged too and I watered so bad all day that I had to have it removed. Then I was drier than ever for a few days. Funny how we are all so different while suffering from the same problem - definitely like a box of chocolates!

[kitty]

Gaye, I am with you 100%. I am treating with two optometrists. The one who inserts the plugs has Herrick plugs himself, so he can completely relate. He even told me what it was like having one flushed out when he experienced ephiphoria for unknown reasons. This he just offered, I never even asked about it. Shop around. You will find someone you can relate to. That might be a very good criteria, looking for an eye doctor who has plugs or who has been cauterized!

[Gaye]

plugs, etc.

Today I was looking for articles on Lotemax and was directed to a posting by MarkL on Dec. 19. He listed some links to information about it and one of them included information from the doctor I saw who was flippant and arrogant to me.

http://www.ophmanagement.com/article...bl\0905bl4.htm

He is Dr. Sheppard who was shown first. At least the article was good.

[kitty]

I had run across this article several times before. I am wondering if I had too much inflammation in my eye when my two lower permanent plugs were implanted, as I have been having a lot of burning, reflex tearing, blurring, foreign body sensation and itching ever since. The dryness is no better. Problem is, I don't know if it's a coincidental flare from DES, seasonal allergies or some sort of irritation from the plugs. As these are the Herrick's, the only irritiation from them would be if they were not put in far enough, but that would probably not result in increased burning, just watering and itching. Could this be the "cesspool" effect I have read about? Would the doc be able to detect the cause by an exam? I'm not sure if I should call the doc or just wait until my follow-up in another week. The weather has been pretty much dry since I got the plugs. We are due for some rain tomorrow, so I will be interested to see if that has any effect. Has anyone else experienced increased DES symptoms following implantation of "permanent" plugs? If so, did you ever learn what the cause was?

[Gaye]

plugs

Hello Kitty - I am in the same shoes as you right now wondering if my new plugs are okay because I feel worse than ever before. My right eye hurts when I blink and it seems like I am feeling the plug. I also have itching, burning and worse DES symptoms and I don't know if this is what to expect for the first few days after new plugs are inserted. My first set did not cause any of this. I dread having to go back to the doctor, but if it doesn't settle down by the end of this week, I probably will have to. I would say for you to give it just a little more time, but don't wait too long either.

[kitty]

Hello Kitty - I am in the same shoes as you right now wondering if my new plugs are okay because I feel worse than ever before. My right eye hurts when I blink and it seems like I am feeling the plug. I also have itching, burning and worse DES symptoms and I don't know if this is what to expect for the first few days after new plugs are inserted. My first set did not cause any of this. I dread having to go back to the doctor, but if it doesn't settle down by the end of this week, I probably will have to. I would say for you to give it just a little more time, but don't wait too long either.

Thanks Gaye. You made me feel better. Misery does love company! As long as things get no worse I am probably OK waiting until my next appointment in one week. Hopefully things will settle down for you soon. I will be interested to compare notes with you over the next week or so. Let me know if you decide to see your doc and what he says, and I will do the same.

[Gaye]

Plugs

Hi Kitty - you are right - at least we don't feel alone in our discomfort and know that there is always someone out there to offer a word of encouragement or wisdom or at the very least, understanding. Let me know how you do too.