Getting plugs - what to expect?

[Tridnod]

Yeah the flouro stuff was the test i did. Maybe TBUT is a different test?
Well anyway, the clinic will book me for a time to insert the plugs and i will tell you how it work out.
I haven't read about so many young people that have this problem, seems like blepharitis and so are more common when it comes to dry eye.

[DrG]

Has anyone here on the board ever had just the uppers plugged?

It seems to me that I remember some favorable reports about upper vs. lower plugging - may date back to the SurgicalEyes boards though.

This idea stems from a study done by Dr. Herrick some years ago. I am not aware of any other authoritative study recommending upper vs. lower, or vice-versa. I simply do the lowers first because they are more accessible.

[Tridnod]

Ok, an update

I had oasis silicone plugs inserted yesterday. Today my eyes are not better at all
I guess it takes a couple of days for the eyes to adjust but i don't even feel or see anymore tears
Should i give up already or have anyone else felt this way before?
Not having any relief at all in the first days and then have improvement?
I was hoping to feel some kinda difference, good or bad, atleast i know theye are doing their job. But as i said, nothing.

am i supposed to book a time for uppers aswell?

[kitty]

I did not notice any significant difference after having just my lowers plugged. It took 4 weeks or so for me to feel semi-comfortable after having my uppers plugged as well. I would think if you were to have some benefit from the lower plugs, you should have felt it within a day or two.

[Tridnod]

Ok, no relief so far. So i guess it didn't workt.
Im going to see another doc for a second opinion, if it really is lack of tears. If that doc approves with the first one i will get uppers aswell.

[Judy]

Have you tried Restasis?

Hello Tridnod,

Have you tried Restasis eyedrops yet? They have certainly helped me and many many others on this site... Personally I'd give it more than four days before I decided to go with upper plugs also. That is just me, tho. Best of luck with whatever you do!

[Tridnod]

Thanks Judy. Restasis isn't available in Sweden as far as i know.
I'll give it another week before i book a new time with my doc, takes about a month before i get an appointment so there is time for me to evaluate the lowers.

I don't know if it's just me hopping for a better situation but i somehow can't accept that my DES is only due to lack of tears. My eyes looks so watery, not less then my friends are but still so much problems. My doc only did a 1 minute test with that flouro liquid and he didn't give me straight up "you are not producing enough tears", more like, "well, you kinda have a less amount of tears then normal and well, the stability of the tear film looks fine, a little bit unstable on the right but thats ok".
Those word are not making me comfortable about him making the right diagnos.

Well, i guess i will now for fact in a month or so but i really don't like my situation at all. Last week i hade to quit my new job just after a day because i couldn't stand the envoirement. It was supposed to be the start of my career and all.

[Tridnod]

An update!

I got a plug inserted in my right upper puncta. Now i should be pluged in both upper and lower on that side. But.....nothing!!!
I can't feel anything at all. It's like they never went in.
Im sorta confused cuz my DES is supposed to be moderate and alot of people with severe DES had major overflow. Atleast there should be som kinda difference. Anyone else had this experience? I had the lower inserted a month before the upper, maybe it has fallen out or something.

Going to another doc next week to get a second opinion. Atleast to check if the plugs really are there.

[kitty]

It took me a few weeks to notice any real difference after getting the uppers plugged. It is probably a good idea to get checked to make sure the plug did not fall out. Not everyone has overflow. In my opinion, these terms of mild, moderate and severe are misleading and difficult to be measured with any sort of consistency or objectivity. I suggest you judge the effectiveness of your plugs only on your own response to them. Don't try to measure your success or failures against what others report. Success for you might be a slight reduction in the use of drops. It might be a dramatic improvement in how your eyes feel. Everyone is different. Be patient and listen to your body. It really helped me to keep a diary of how my eyes were feeling each day. This helped me to make an informed decision on whether or not the plugs were helping.

[sparrow]

got the uppers done today

I just got my uppers plugged today, had my lowers done in June and no benefit from the just the lowers. so far, my eyes have been tearing very nicely since this morning when I had the uppers done. I even wore my contacts for 5 hours today w/ no discomfort so that's an improvement. Will see if I can get the wearing time up to 8 hours and that will be considered a major success by me!!! Hope this tearing lasts. with just the lowers plugged, I had some nice moisture for the first day, but it was gone after that. Hope the plugs remain comfortable, I can feel a little pinch sometimes when I look towards my nose or at an angle. Will keep you posted.

[indrep]

Sparrow,
As someone who wants people to really benefit from all that they do to relieve the symptoms of dry eyes, I would really like to see you limit the contact lenses wear to "occaisionally". Even though technology has a come a long way in the materials used in CLs they still block a significant amount tear from reaching your cornea. If the cornea is not getting nutrition then it reacts in ways that cause discomfort.

[Tridnod]

ok, can the doc really determine if the plugs are there or not? Im using oasis formfit longterm (permanent). If they went down thre the puncta for example....
well im really bothered about this cuz this is the last way to get relief threw healthcare. Restasis is not an option cuz i live in europe. Really hope there is some issue with the plugs not being in the right place.

[indrep]

Tridnod,
No and yes. The doc cannot just look and tell if they are there. He would need to put some type of "dye" in the eye and watch to see if it is going down in the puncta. It would take all of about 60 seconds to carry out.

The only explanation for the plug not being there would be if the plug was not inserted properly and was pulled out. This would have happen very soon after insertion. This could have happened if your puncta was dilated before insertion and the punctal ring did not keep the plug from rising "out" of the intracanalicular canal and then you swiped your eyelid and pulled it out. After several minutes if this was the cae you most likely would have only pulled OFF the part that was out of the canal. This is due to the material being 90% water when hydrated.

[Tridnod]

Thanks for the reply indrep. Really explained it...next week i will now for sure if im doomed or not

[Flick]

I currently have Oasis FormFit in both my lower puncta, and my doctor has confirmed that they are still there using one of his scopes (I'm not sure which one, I don't think it was the slit lamp). He told me you can't see the plugs by naked eye, you need the scope to look down into the punctum.

Indrep - maybe I missed this in a past post, but assuming that you are employed by a company that manufactures and sells plugs, would you be comfortable disclosing which company that is?