What to do if you have lost a plug

[Matt0029]

I guess a lot of people who have plugs go through this. I have only had them 12 days after the initial discomfort my eyes seem to improve then went back to baseline. I even went back to the clinic after 6 days to ask about the symptoms I had of life changing relief then back to baseline again. But things have continued to be bad. And I am almost 100% sure I have lost my right plug I'm pretty sure I can see the whole in my tear duct in my right eye. Left eye I cant because of plug. And I cant feel it in my right eye when I move my eye to the inner corner. Any advice on what to do? So fed up with having sore painful eyes at the moment.

[Hokucat]

Hi Matt. Likely the right plug just fell out and is no longer in your eye. I've had that happen three times. Your tear duct in that eye is not red or infected, is it? You should go back to the clinic so they can check and put in another one. Maybe consider having the upper ducts plugged at the same time too, if you've only had the lowers done so far, and see if that helps.

[Matt0029]

Thank you it doesn't look infected no. Did u lose your first one quiet quickly? Its going to end up quiet expensive if this keeps happening. I've already been back once after 6 days because I started having issues.

[Hokucat]

Yes, the first time mine came out within a month or so. When the doctor replaced it, she said she was using a slightly larger plug, because it's possible the other one was not big enough so slipped out.

She also asked if I slept on that side, because my eye pressing against the pillow could cause the plug to come out, or also if I was doing my lid scrub too close to the plug or using too much pressure when applying warm compress. So it could be a number of things that caused it to come out. Just be aware of these things in your control, but sometimes no matter how careful you are, the plug still somehow comes out...I noticed a few weeks ago my right eye felt a tad drier than normal, and then noticed the plug in my right eye was missing!

[Matt0029]

Do you pay for a new one every timw you go? Am abit corncened to go back again not due to the cost. But because I was just there last friday asking about the initial discomfort.

[Hokucat]

It was over several years where three plugs fell out, only the first one happened a month after I first got them. Hopefully your situation will be more stable too after this. But don't worry about having to go back to the clinic again, especially initially when you are getting used to the plugs. Some people have to go back a few times for various reasons, besides the plugs falling out, people's ducts get infected, the plugs are uncomfortable, the plugs disappear lower into their ducts causing problems, etc.

I'm in the U.S. I have good insurance, so the majority of the costs were covered each time I had to get a new plug. But can see how it could get expensive if it keeps happening and you pay out-of-pocket. Some people have their ducts permanently cauterized, if the plugs indeed help, but have the tendency to fall out.

[PRK]

In my experience if your plugs are scratchy and have a tendency to fall out they are probably not sized correctly. I remember I had to try a few different sizes before I found plugs that were comfortable and stayed in place. I'’ve have a .5mm silicon plug in my lower left eye duct and a .6mm plug in my upper right eye duct going on 6 years now. I used to have all four plugged but the other two fell out years ago. I should probably just get them cauterized but I figure not to try and fix what isn'’t broken at this point. I do notice I can feel the larger .6mm plug more if I look all the way to the side so the plug is directly over the cornea but it’s not really noticeable. A plug that’s the correct size will sit slightly in the tear duct so the cap isn’t rubbing against the eye and that also helps to keep it in place.

Also I’m not suggesting this but just for information purposes I’ve put my own plugs back into place quite a few times. Usually it would still be in my eye somewhere and I could push it into the corner, fish it out and put it into a contact case with cleaning solution. Then place a clean black garbage bag over the sink so I could find it again if I dropped it. Then wet my finger till it was damp so the plug would stick, stand it up on my finger on its cap and carefully press it back into the tear duct. The cap would prevent the plug from going in any deeper than it was supposed to. In the end I was better at putting in my plugs than my doctor. A couple times he was putting one in he inserted it too deep and the tear duct swallowed it. Also eventually could feel/ see if a plug was getting loose and would press them back down gently to buy some more time. Though if they are getting loose they will fall out sooner or later.