Upper Plugs Different

[np1981]

Are upper plugs different in shape to the lower plugs? Or are they just the same plug placed in a different place? I lost an upper plug recently and the local eye doc (who I don't normally see) told me he couldnt replace it, but was able to replace the lower one if it had fallen out.

[SusieD]

Yes, they are the same plugs. I had one doctor tell me he couldnt do the uppers. I think it was because he didnt have much experience with plugs - he said he wouldnt be able to get it in. You have had plugs in your uppers before so why should you not be able to replace it? Id go back to the doc who placed your originals if you can.

[DrG]

Yes, they are the same plugs. I had one doctor tell me he couldnt do the uppers. I think it was because he didnt have much experience with plugs - he said he wouldnt be able to get it in. You have had plugs in your uppers before so why should you not be able to replace it? Id go back to the doc who placed your originals if you can.

The anatomy of the upper puncta is the same as the inferior puncta, but sometimes the position of the eyelid and the approach makes placement of the superior plugs awkward using the slitlamp. I typically like to use a loupe magnifier and do it out of the slitlamp. I find that reclining the patient and sitting behind their head permits me to use the same approach to the upper puncta as with the lower puncta.

I once had a very difficult patient with very recessed eyes and small puncta, which made it very difficult for me to insert the upper plugs in the traditional way. In that particular case, an operating microscope was necessary.

[np1981]

Susie, did you ever get the upper plugs installed eventually? If so did you notice much difference?

[SusieD]

No havent had them done yet - doc wanted me to wait for a couple of months before doing uppers. I have another appointment in a month so will have to wait till then - I do need it though, Im sure.