Herrick medium term plugs....

[kitty]

I have a question. My upper Herrick intracanalicular medium term plugs are supposed to last 4-6 months. I got relief for about 4 weeks and am now, 6 weeks post plugging, feeling like I did before I got the upper plugs. What might be going on? Could the plugs be dissolving already? Could they be defective? I hate to think that my DES got that much worse in such a short amount of time. I'm debating on whether or not to go back to my eye doc. I'm getting so tired of getting examined and plugged!

[shells]

Hi Kitty,

Sorry to hear that your plugs don't seem to be helping anymore. Is there anything else in your routine that changed recently that might be adding to your discomfort, or maybe a change in the weather or something? One month seems kind of early for them to be dissolving. Are you sure that they have not fallen out? I think I have the same kind as you in my upper in my left eye. I've had it about 2 weeks, but still don't really notice much of a change unfortunately. I think my left eye is just hopeless. It is weird though, I can't see it and I never could even though they claim you are supposed to see it with a light. Anyway, I know how annoying it is to keep having to go back to the doctor, but maybe that would be a good idea just to see what is going on if things keep staying how they are. Good luck and I hope that things get better for you soon!

-Shells

[kitty]

I can't see the uppers like I can see the lower plugs. They are a bit different in design in that the lowers look like a blue golf tee and the uppers are just a blue rod. I'm fairly sure they have not fallen out but I can't rule out that they have not migrated back the other way. I will try the "taste test" with some Patanol or Tobradex and see if I notice it as much now as I did before getting the upper plugs. That should tell me if the plugs are doing their thing or not. The only change in my routine is no exercise because I broke my foot. I'm also not drinking as much water as I was, but I am drinking enough. The weather has not changed.

[shells]

Hi Kitty!

I hope things are going well for you. I have a question about these Herrick plugs. I had the 6-month dissolvable ones put in my lowers about 2 weeks ago, but I can't see them. This is probably gonna sound dumb, but where exactly do you see them? Is it through the punctal opening, or can you actually see them through your skin or something? When she first put them in, I looked before I left the office and saw the one in my right eye sticking up, so she pushed it down a bit, and I haven't seen either of them since. Now I'm back to wondering if they are even in there or not. Unfortunately I could not tolerate the ones with the cap, so I guess that is how its got to be for now. One thing is for sure, if they are still in there, they really aren't doing much of anything .

-Shells

[kitty]

I did not see much benefit from plugging just the lowers. Stand in front of a mirror with good light in the room. If you gently use your finger, apply a bit of pressure just below the punctum, and then pull down so the skin around the puncta is taught, you should be able to see a faint blue (my doc says it is purple) line. That is your plug. If you cannot see it in plain light, do the same pulling procedure but with the lights off hold a flashlight or better yet a pen light against the skin near the punctum. Be careful not to burn yourself. You should then be able to visualize the blue or purple line. If you can't the plug has probably dissolved or migrated further in, or fell out at some point. There is a chance that your doc might have used the older plugs, the ones that are not radiopaque (blue/purple). If you can't see them, make an appointment and go in and have your doc take a look.

As for me, my DES symptoms (burning, excessive dryness) started returning about 11 weeks after I got my uppers plugged. I am now roughly 3 1/2 months in and am feeling as if they were never put in. I guess they have dissolved enough that they are allowing tears to drain again. My constant runny nose has returned which happened before due to reflex tearing. I see my doc in about two weeks for follow-up and will ask for the permanent Herricks to be placed in the uppers. My doc said that the medium term plugs would last 3-6 months. He also said that he used too small of plugs in my uppers, so that might have something to do with how fast my symptoms returned. As an FYI, I never could see my upper plugs. They are the medium term ones. I have only been able to see my lowers which are the long term/permanent type. Both of mine are Opaque so I should have been able to see the uppers, but I guess I just could not get the right angle or something.

You might be interested in visiting the Lacrimedics web site and looking through the physician info link. Lacrimedics

Good luck to you!

[shells]

Hi Kitty!

Thanks for the description on how to find the plugs. My doctor did use the blue ones because I asked her if they were supposed to be visible and she said yes. I was glad because I wanted the ones I could monitor. I guess I didn't ask her specifics because I thought it would be obvious. I will try to find them with a flashlight later and see what happens. I had a 6-month blue Herrick put in my upper left a few months ago, and never saw that either. I guess with all of these, I've never seen much difference either way, so I can't tell what is going on.

My doctor told me the 6-month ones last about 5-months on average, but ofcourse as we know everything is different for everybody! I hope that you are able to get the right combination again and get some relief soon. Thanks again for the info.

-Shells