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What is/was your experience with punctal plugs?

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  • What is/was your experience with punctal plugs?

    My question is about punctal plugs. For some reason, the idea of sticking foreign objects into my tear ducts does not thrill me. Hard to believe, I know! And, of course, on the web, I see the stories of things that go wrong with them. Irritation, inflammation, migration, etc. Realistically, what kind of experience with punctual plugs do most people have? Is it just a tiny fraction of people who have problems with them, or is it more? Are they safe? Any problems with getting them in, or out? I've been doing the eyedrops for about 2 months now and I haven't seen any improvement at all, so it's clear that I probably need to move on to the plugs.

    Any and all comments will be appreciated.


  • #2
    I have had plugs for about 6 months now with no problems. The only irritation is that i can slightly feel them if I look to the inner extremes. As for safety, my opthomolagist (who is a corneal disease specialist), says that they are very safe and hardly ever have complications. The complications are, however, that inflammation will linger longer if you have plugs, if you get an infection they must be taken out (they can be taken out quite easily if needed), and if they get dislodged down your tear duct (he said this is very rare), then a minor surgery may be necessary to remove it if it cannot be flushed out. Also, if you are not careful, rubbing it the wrong way can remove the plug. I have never had any of these complications in my 6 months. To avoid inflammation from the insertion procedure (which is also very quick and painless), my doctor likes to put his patients on anti-inflammatory drops before inserting plugs.


    • #3
      I had lower plugs inserted, which didn't do anything for my dry eye. I have MGD and I've been told the plugs work best for people with AD. I had to have the left one removed several weeks after insertion because it was extremely uncomfortable. Every time I looked from side to side I felt like it was scratching my eye. Several months later the right one, which was originally very comfortable, started to do the same thing. When the optometrist tried to remove it, it tore. So now I have a piece of a plug lodged in me that they can't remove without surgery. I've talked to multiple people who have had to undergo surgery to remove them due to them becoming lodged and a resulting infection. I think some are safer than others. I had the permanent kind, which is the same kind the other dry eye sufferers had that had the problem, so it may just be with that kind of plug. You may opt for temporary ones to see if they'll work and if it's worth the risk. Hopefully my experience will give you some insight. Good luck :-)


      • #4
        I started out with the two lowers plugged. One came out as I was driving away from my eye doctor's office the day it was put in. Went back and had it replaced. Both of those stayed in, they did not help much. I initially had itching and irritation that resolved within a couple of weeks. I eventually went on two have the two uppers plugged. That trapped in too many irritants causing one of my eyes to tear up and run down my face. They were not comfortable tears either. Had that one plug removed. 2 of the remaining plugs eventually migrated. Don't know where they are. The occuloplastic surgeon I consulted regarding the plug migration said plugs would not help me so it was of no use to have them put back in. All of this occurred over 2-3 years.
        Every day with DES is like a box of chocolates...You never know what you're going to get.


        • #5
          I've had plugs a few times and didn't mind them at all. Unfortunately, because I produce little to no tears, my ducts force them out (or they dissolve quickly if they are temporary). The first time I had them put in, over 10 years ago, they really helped a lot. Now, they help some but not a whole lot because my ducts are closing up because my body is trying to save whatever moisture my eyes have; one doctor thought I'd had the lower ducts cauterized because they are so small. I've had upper and lower plugs. They don't hurt going in if your doctor is good (I've experienced both).


          • #6
            Plugs can become uncombtable

            I had two lowers plugged about 4 years ago, the right or left one, i cant remember now, came out about 2 days after insertion. Had a big one put back in. Good results for 2 years and then....... Really dried out and went back to optho who said he could plug uppers as well. Had two uppers plugged for about a month and although they teared, the dryness persisted under the unrefreshing tears. Had the uppers removed and went on cyclosporin which helped a bit after 5 months. Left plug expelled and is now closed
            on its own account due to the infection scar. My tearduct actually bled! Still have the larger one of the two in the right and it is now pretty uncombtable and I feel a definate scratch when I move my eyes although the optho says it is sitting " well down" in the duct. I somehow dont agree as it really irritates now. I am in the process of wondering whether to have it cauterised or just removed. I am in an awful flare with both eyes and am worried that I am now trapping inflamatory components. Which is bad news as the left is now scarred shut!
            I supposedly have sjogrens but maybe if the DE is a different cause for you, it might be worth a shot.
            They seem to help a lot of people in the first instance but the effect has a habit of wearing off.


            • #7
              I initially thought I liked my plugs, which were the temporary kind. But because I was having reactions/allergies to my rx and OTC drops, the plugs ended up making matters worse by keeping the drops in my eyes longer and not allowing them to drain out quickly.

              Also, the doc put me on Restasis at the same time, even though the Restasis website says Restasis does not help people who have plugs.

              If you don't have allergies to ingredients in drops, it may be worth trying. Putting them in wasn't horrible and was over quickly.



              • #8
                Thanks for all the comments, everyone. It sounds like they help some people, and just wind up causing more problems in others. I guess that's what worries me; I just don't want to be made worse! And I'm still not sure they're even right for me. My biggest symptom is light sensitivity in the left eye. I don't have MGD. And I don't wake up with crusty eyelids. I get some eye pain now and then but not horrible. Some grain-of-sand-in-the-eye feeling occasionally, but again not all that often or horrible. Mostly it's the sun that causes major eye pain. And looking at TVs and computers can be difficult.


                • #9
                  Are you sure your eyes are dry? Have you been checked out for eye strain or irregularities in your iris (uveitis) ? If artificial tears have not helped you in the past two months, it is possible that your light sensitivity is not dry eye related.

                  Best of luck in your search for help.



                  • #10
                    I really like my plugs. I think they help a lot and really aided me in reducing initial inflammation and pain. I have no problems with my plugs, I've had them for a year and a half. They don't rub and I forgot they are in there.

                    I still have really dry eyes but I'm happy with the plugs. My optometrist is extremely experienced with dry eye (he lectures optometrists) and with plugs. I think practitioner experience may play a large role in getting the proper plugs inserted well.