I was curious which members had mentioned being helped by punctal plugs or punctal cauterization. I know how long it can take to look through the forums to find opinions on all the different treatments. So I did some research and below are some of the posts and the forums from which I found them. Is there anyone else out there that plugs or cauterization have helped? Happy holidays!
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Tankie
Dry Eye Patient
Join Date: Aug 2010
Posts: 254
#1
Free Lipiflow (sort of) and Punctal Plugs Overcame my Dry Eyes
13-Feb-2015, 20:14
Hi everyone,
I haven't been around in a long time since I am no longer struggling with my dry eyes. I do still have the problem, but it is very manageable, I don't take any drops ever, and I've been working successfully as a teacher for over 2 years. I am now 28 years old. I started with my dry eyes when I was 20, and I didn't overcome them until I was 26. So how did it do it?
1. Hot compresses never worked for me. The towel would get too hot, too cold, I'd burn myself, or I'd get the temperature just right but only for a few seconds and then it would cool off. Standing under the hot shower spray with my eyes closed never seem to get the job done either. However, what did work was buying a space heater that sprays out hot air on my face. Here is the one that I bought: http://www.canadiantire.ca/en/pdp/li...l#.VN6SQ_nF_II. For what it's worth, this will only heat a very small room, but that's not what you are buying it for. For me, I would lie down in front of it with my eyes closed for 10 minutes every morning when I would wake up. While doing so, I would also do blinking exercises and sometimes use my fingers to help excrete the oil out of my glands. This is the only treatment I do for my eyes to this day. I also use my car radiator for this, where I will turn the heat up to the max, aim the vents at my face, and melt the oil while driving. I know that might sound a little scary, but I don't take my focus off the road for even a second and it works really well. However, for the driving version of this, I do it with my eyes open. I also do the blinking exercises and sometimes use my fingers to excrete the oil out of the glands. Feel free to do this for over 10 minutes if you feel that 10 minutes isn't long enough and it is helping. By the way, this is what I meant by "free lipiflow" because all lipiflow is is a device that melts the oil for 12 minutes non stop, and then they will charge you $750 per eye. The option I present here does the same thing, it's free, and you can do it to your heart's content.
2. Punctal plugs: to this day I still have my lower punctal plugs in. Before I discovered what I just mentioned with the space heater and melting the oil, I tried plugging all 4 ducts, but all that lead to was tear overflow and getting a rash around my eyes due to wiping away the tears all day long. It cured the problem since there were so many tears in my eyes, but the rash was very painful itself and I had to do something about it. I then tried leaving my lower plugs in, but putting flow controller plugs (punctal plugs with holes in the middle) in my upper ducts to control the amount of tears that could drain away while keeping some of them in the eye, but I still had the overflow problem with this and so I had them removed. After this, I discovered the space heater method, and since I still had my lower plugs in and they weren't bothering me, I've decided to keep them to this day.
3. I realize that this is not a religious forum, so I'll keep this comment brief but I am a Christian and I believe that drawing near to God played a large part in me getting over the dry eyes. I'll just leave it at that, and I hope this comment doesn't offend anyone.
All in all, I recommend anyone with dry eyes to try my space heater method and getting all 4 punctal plugs put in, and then if you have the overflow problem, get the top ones removed. One major word of caution is that I've had punctal plugs put in by 4 doctors in my time, and 2 out of the 4 doctors did a terrible job of inserting them and they fell out by the time I got home. The way to check if the plugs are actually still inserted, is to look at the inside of your eye and search for a black dot. If you see the black dot, it means there is no plug there since that's the normal drainage duct. If you see a little white plastic plug there, that is good since it means the plug is in. You can observe the black dot (or white plug) in both your lower and upper punctum if you pull your eyelid back.
Good luck everyone, I hope this helps you all and that this will be the thing that turns your life around!
Tankie
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willwork4tears
Dry Eye Patient
#1
I'm baaaaack!
06-Apr-2012, 14:46
Sorry for the lengthy hiatus from participating in the DEZ. I feel bad that I haven't been on in close to a year but I'm going to try to get on here and there.
The good news is that one of the reasons I've been away is that I haven't needed the DEZ as much for advice on my dry eyes because I'm doing much better. I had lower punctal cautery in September 2010 and started using Lacriserts shortly thereafter and this combination along with the 1% cyclosporine I had been using for a while has been a life changer!
Of course, for those of you that know me, you know I have Sjogren's, so I'm still dealing with all those issues as well. Life is not perfect, but at least I don't feel like clawing my dry/gritty/sore eyes out of my eyesockets any longer!
But I still want to be around to be a support to others. So I'll try not to be such a stranger.
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SunshineinCalgary
Dry Eye Patient
#8
15-May-2012, 21:51
Ladiva,
I guess I must be lucky "in some way". I have permanent plugs inserted (lower ones for 8 years and upper ones for a year) As a matter of fact, I don't even know my lower ones were there until my optometrist told me. I guess the success of plugs depends very much on your eye specialist. I know some didn't want to do the plugs as they had little experience doing them. My specialist was very good in doing plugs, that seems to be his expertise !!!
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glenda
Dry Eye Patient
#13
03-Jun-2012, 14:21
I had plugs put in on May 28. The first day I could feel the one in my left eye, but the 2nd day, I could not feel anything. I do not know which kind I have, all I know is that they are a different size in each eye. (mine are lower plugs) I think they are umbrella, as when I pull my lower lash lid down, I can see a white top. Otherwise, I would never know they were there. They have helped. I am not pouring the drops in every 45 minutes. Sometimes I can go 2 hours without putting in drops. Over night I put in liposic around 9pm and when I wake at 8, there is no gunk on my lids and my eyes are not dry.
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kanon
Dry Eye Patient
#2
04-Jun-2012, 07:45
Hi Dave,
Years ago I had my upper puncta cauterized (plugs kept coming out) and that made my eyes great! Really helped my dry eyes. My eyes became a little "too teary" but this was ok for me since it was SO much better than the misery of the dry eyes. (Now, years later, I am considering having my lowers cauterized as well, since my eyes got messed up recently from a bout with conjunctivitis...Have had plugs put in the lowers 3 times in the last month and they keep coming out. Want to get them cauterized, but then I would have 4 cauterized puncta, and that permanence sort of scares me....)
You posted on May 21, did you make a decision yet about cauterization? Ashley
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PAllen
Dry Eye Patient
#3
19-Mar-2012, 20:44
Yes. The relief they gave me was instant. I did have to get all 4 done. Just the lowers didn't do much. I had the plugs fall out lots of times. a couple ended up in the corner of my eye, but they're soft and pliable and I just took them out.
good luck, Jen.
needhelp640
Dry Eye Patient
#2
19-Mar-2012, 19:40
Hey there,
You should go forward with it. Plugs have helped me a lot and they should help you with ur RCEs. If your afraid of them falling into your eye then you cam get temporary intracranular ones that sit inside your sinuses, dont really move anywhere and get absorbed by your body in about a month. It would also help you decide whether or not to get silicone semipermanent plugs
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SAAG
Dry Eye Patient
#10
22-Jan-2013, 20:12
Originally posted by patientpatrick View Post
Saag PCL is apparently the material the extended temp ones are.
Ok... well sounds like those may be similar to the kind of temp. plugs I had - mine were the kind of temp plugs that are supposed to slowly dissolve over 3 months. Also, I had those 3-mo temp. plugs in all 4 puncta at one point and I had no overflow.
However, with permanent umbrella-style silicone plugs in my lowers, and uppers cauterized (as long as they stay shut haha), I definitely have overflow and it totally rocks compared to being so dry.
So, moral of the story is.... try the permanent ones and odds are good they'll be even BETTER than the temps are at 100% blocking your puncta.... so there's still hope for you to get overflow... no worries!
And as others have said, even overflow is not always a perfect solution since if you don't have enough lipids in your tear film, the tears may still evaporate too fast... but still, a lot of people are way more comfy with overflow compared to not, so I say give the permanent plugs a try! Plus, it's possible that with some of the aqueous deficiency relieved, there may be less inflammation on your ocular surface, which may end up leading to less inflammation in your meibomian glands and improved meibomian gland function... again, you won't know if you'll fit this profile unless you try, right? (Not saying that plugs can't worsen MGD too... but not everyone is the same)
Keep in mind that some docs may hesitate saying something along the lines of "well, if the temps didn't help much, then no point in trying permanant ones". I'd respond to that by saying that you don't know unless you try and there are many reports of people finding the permanents doing a better job of fully blocking the puncta... PLUS, if the permanents don't help, you can always have them removed so it's not like you can't back out later... I can't emphasize enough the fact that you have to at least TRY to see how YOU react to them.
Originally posted by patientpatrick View Post
I'm debating whether to just give up on them or pursue the permanent ones. I'm still quite confused since the temps seemed rather ineffective.
No offense, I'm going to be blunt here... please take this in the nicest possible way I see no logical reason NOT to try the permanent ones since ...
a) you noticed "a bit" of improvement with the temps (that could be a sign of good things to come with permanent ones!!!)
b) there have been tons of people on these forums over the years who can vouch for the fact that permanent umbrella plugs worked better for them than temps (if I recall correctly, my own doctor even noticed this in some of his patients... so there is another source of that info)
c) the permanent plugs do not have to be permanent, so if the end up causing more negatives than positives for you, it's easy to get them removed
d) you have no way of knowing for sure whether or not permanent umbrella plugs will help you unless you TRY them... so do it!!!
farmgirl
Dry Eye Patient
#22
22-Jan-2013, 23:33
OK, for what it's worth I gotta add my two bits. I had temporaries in all 4, that helped. I got the uppers cauterized and umbrella plugs in the lowers, that helped a LOT. The lower right came out twice so since I didn't have time to get a custom fit one put in I had a longer lasting temporary put in. Now that eye bothers me somewhat where the left doesn't and I know that it isn't plugged as well since at times I can taste my restasis in the back of my throat. Moral of this story is, like SAAG says temporary plugs don't work as well as permanent removable plugs.
At times I get a wee bit of overflow on the left which I don't mind but sometimes the eyelid gets a bit sore from the salt off of my fingers when I wipe it away so I need to resort to carrying a tissue to keep my fingers off of the lid. Hope you find more relied with permanents and I highly recommend you try them...cheers...F/G
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Shahara
Dry Eye Patient
#1
Almost no dry eye now...
19-Dec-2011, 16:57
I was here regularly sometime back. But I thought I should just peep in here to see wots going on.... ( I live in germany!)
My dry eye began somewhere around 2002 I guess. I use to live a very unhealthy lifestyle, ate loads of sugar and I hardly ever ate any vegetables or fruits in my teens.
My dry eye got so extremely worst somewhere around 2004/2005 that I had to use drops almost every half and hour. I was stuck at home unable to go out due to the severe dryness. I was suffering from depression and was looking tired and sick 24/7.
After seeing many ophthalmogists but without any useable help. Somewhere around 2006/2007 I got plugs and restasis. Plugs fell out many times so my eye doc closed my upper tear ducts (What is the english definition for that?)
I took restasis for a while but was scared about long time sideaffects. After a long time suffering I decided to go to an alternative practitioner. As I took antibiotics for a very long time he asked me to get the intestinal repair with detoxing measures and a systematic propogation of the gut flora, which suffer damage from antibiotics. I took natural bacterias in form of drops and powder for a long time. My dryness was slowly disapearing.
Now I hardly ever take any eyedrops. I hope this might help someone...
Thank you
Shahara
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ryanross
Dry Eye Patient
#2
10-Nov-2011, 18:52
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.
tearless2
Dry Eye Patient
#10
15-Nov-2011, 23:20
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.
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PRK
Dry Eye Patient
#1
6 years after PRK dry eye mostly gone with two punctal plugs
06-Nov-2017, 14:31
It’s been almost 6 years since I had PRK and my eyes are feeling good. I used to have four punctal plugs but two of them fell out probably 4-5 years ago and I waited to see if I could get by without them. So now I just have two plugs, one in each eye. I have a .5mm Eaglevison Superflex plug in the lower tear duct of my left eye and a .6mm Superflex plug in my upper right eye. I don’t really notice them and they have never really given me any trouble. My eyes are pretty normal nowadays and I haven’t really had any major problems for years. My eyes still get a little dry when I’m sleeping but most nights it’s not really noticeable. Every 2-4 months I do get a night where my eyelids stick to my eyes a little and that can cause some pain for a few minutes sometimes but then my eyes start to water and it goes away. They can still get a little dry if I’m doing dusty yard work or stay up really late. I don’t have drippy eyes like I did with four plugs but that wasn’t all that bad anyways. I haven’t used drops of any kind for years. If my eyes get a little dry I just close my eyes and while they are closed I squeeze my eyes shut a few times like I’m yawning to get my lacrimal glands to release some tears. Also if I pretend to yawn a few times I can usually encourage a real yawn which makes my eyes water. Anyways that’s pretty much all I have for an update. Hope everyone is doing well.
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indrep
Moderator
#9
05-Oct-2012, 06:59
Having been around punctal plugs for 27 years I could write till everyone went to sleep like Rip Van Winkle.
The best plug is the plug that works best for the individual. Having said that there are some plugs that are more prone to problems. Primarily avoid intracanalicular plugs of the long term variety if at all possible. However there is an option available that does not have the same reported issues as the other types. Also hard silicone plugs tend to create more problems than soft silicone plugs. Plugs with designs of the anchor that can create pressure points also tend to have more reported problems.
Also some problems occur when the insertion technique might not be as good as it can be. This tends to happen with temporary plugs that have less than polished edges.
Having said all of that my wife has been plugged with various plugs for 20 years, the most recent almost 9 years ago with intracanalicular plugs. Punctal plugs have helped a great many people over the years and the vast majority of problems could be avoided if the proper plug was chosen and the proper technique used for insertion.
http://www.dryeyezone.com/talk/forum...ctal-plug-tips
indrep
Moderator
#11
06-Jun-2011, 17:20
I would look for a plug that has a continuous anchor and neck. Something that eliminates pressure points. The more surface area that tissue touches the less likelihood there is of irritation to the skin leading to an inflammatory response.
A study from a group in Iowa, can't remember name (17 years ago), measured puncta using the EagleVision gauge (most popular) and found 40% of puncta measured .6, 30% - .5, 20% - .7 and 5% each for .4 and .8. It also showed that 30% of the patients had different size puncta.
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MBC
Dry Eye Patient
#6
16-Mar-2011, 10:53
I have had plugs for a year and they really help a lot. The problem is that they keep falling out and I had them replaced about 7 times already. They have different sizes and they are difficult to fit. However if you can get someone who really cares about fitting them correctly I think you will find they help very much. You have to be careful not to rub your eyes because you can rub them right out of your eyes. It does not hurt to get them put in
Rick0517
Dry Eye Patient
#8
19-Mar-2011, 11:46
Punctal Plugs
Thanks to everyone that replied. You have sent me some very good and important info. I am currently trying the 7 day temporary plugs and now on day 4 without any problems. They seem to extend the time between using eye wetting drops by as much as 4 hours! I'm not experiencing any uncomfortableness at all which is a welcome surprise. Still having burning with certain brands of drops and my glaucoma meds though. Next week I'll try the 3 month temporary plugs, if my insurance covers it. I didn't think to check( gibbet - extra thanks for that suggestion! ). I'm trying to avoid getting the gold weight in my eye lid for now but that may be necessary eventually.
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djeanwithdryeyes
Dry Eye Patient
#6
10-Dec-2010, 18:30
new to plugs
I was having DES problems and the doctor wanted me to try plugs. I read the mixed results here on this website. So I wouldn't do it! Eye pain got worse so I finally agreed to bottom to be plugged with 3 months Oasis. The doctor showed me, the plugs are blue foam like plugs and the plugs are installed into the tear duct, so no one can see them. The plugs form fit to the tear duct, expand in 10 minutes to fit.
On Thursday, Nov. 9th - I had the top plugged.
As for me, there has been a good change.
To be honest, I am still NOT thrilled about the thought of having something artificial stuck in my tear ducts but my eyes do seem better!
Anyway, so far so good!
mjf79
Dry Eye Patient
#7
02-Feb-2011, 22:46
I have traditional plugs put in, but my newest doctor buried them further in to where no part of the plug touches my eye. My tear duct sits angled in more than other people's, so when the first doctor put them in they scratched my eyes and caused major problems. He tried 3 different times with different sizes. The new doctor I go to simply buried them further in and I've had them for 2 years with no problems. If I need them out he will simply flush them out. I had him do this once to see if plugs were creating an increase in itching. Well, they were, but I take the itching over the pain of the dryness without the plugs. I use an allergy/anti-itch drop on days that my eyes are itchy.
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LasikEyes
DryEyeTalk Newbie
#1
4 PUNCTAL PLUGS + and I'm BETTER
09-Oct-2012, 06:09
...... I wanted to share my experience with all of you because I know how $hit daily life can be when you have dry eyes, no one understands and takes you seriously ... even more annoying
Mini HISTORY Lesson:
-Wore Contact Lenses since I was 12... (noticed I had dry eye since whenever I wore them = veiny reddish @ inner corners)
-Had the ''Custom-Wave Front" Lasik Surgery done at 19 ... (turning 22)........ made eyes even MORE DRY-ER and only feeling worse as months go by= imagine feeling like you have a contact lense in your eye you slept with all night, all week perhaps, constantly having that feeling as if a MINI-FAN was blowing in your face...and there is no wind near! ... or even worse somedays... feeling as if you swam wide-eyed in a chlorine pool with your dirty contact lense and whilst having the mini-fan blow in your face.......(o yea red veiny eyes= STONED LOOK, because of the pain of your eyes u can barely keep them open normally)...........NEED I SAY MORE!!!??? uuuuuuuaghhh !!!
THINGS I TRIED BEFORE -HAND
- So I've read about warm compresses and even an optometrist told me to do so...BUT I've tried WARM and (ICE)-COLD... I've found ICE-cold feels more soothing and decreases redness way more! ( just a handful of ice+water + face towel)
-REDNESS-RELIEVER Eye drops.... *i'm telling u...DONT depend on these! I suggest u stay away from these altogether anyway they are TEMPORARY and will only make u worse and feeling more dry even more if u over-use, for relief stick to lubricant drops only!!
-LUBRICANT DROPS/ EYE DROPS
After testing a couple of staple brands... I always ended up buying GENTEAL...(liquid/gel drops)... still I was going through a bottle every 2 weeks @ $12 a bottle...8 drops a day or so
-MEDICATION
5 month run of accutane 40 mg (10 mg off and on), it is said to induce dry eye
-SUPPLEMENTS
I Know for sure that the ''NATURE'S BOUNTY'' Flaxseed Oil Capsules
http://www.drugstore.com/natures-bou...2?catid=183250
I started to take in 2011 helped me with dryness and thus a tad lessened some redness, noticeably enough..... but not completely satisfied to stop looking for solutions
ALSO I ditched the flaxseed for 2 months to try the EXPENSIVE ''PRN'' DRY EYE OMEGA Benefit pills ''Physician Recommended"........ but I saw no major difference... and think nature's bounty is better anyway
Also tried ''THERA TEARS fish oil capsules''.... again i would still choose nature's bounty flaxseed
PUNCTAL PLUGS + short run on FML drops:
-@ first tried TEMPORARY PUNCTAL PLUGS
didnt notice much of a difference
for the 3 months it was supposedly to last there
-*** WENT TO A DRY EYE STUDY***, where obviously I qualified the UN-BIASED DOC there noted that I indEED have very dry eyes, where he preformed tests on me...(i.e- schirmer test, where it revealed I didn't produce enough tears... NORMAL people tears get a 11-15 count..whereas I got 1-3 count)
- PERMANENT LOWER PLUGS + PRESCRIPTION STEROID (FML) Drops
found noticeable relief with lessened red veiny eyes,,I was also prescribed FML eye drops that I was using ,,, but still I wanted more moisture!
-FINALLLY (after much personal research)....GOT UPPER PERMANENT PLUGGED as well !
-so now I am quad-plugged ... initially the LASIK Surgeon and optometrist said I don't NEED uppers done.. but once I told the surgeon that it's been nearly 3 years later and just how many bottles of i-drops I use he gave in ...... There at LASIK they don't and have never BOTHERED to do any formal tests on me like (the schirmer's test, and tear break up test etc)...they just look at my cornea in there handy dandy microscope and see I have no 'dry spots'... welll isn't that just LAZY-NEGLECTful, dumb-of-them since... dry eyes can be an aqueous deficiency !
-VERDICT
I feel much better ... REDNESS Noticeably Lessened! .. although the veins haven't disappeared, it has just subsided and the pigment of what is now pinkish (not red) has gone done alot! i know for sure because before if I spent just 30 minutes on the computer my eyes would get soo red and feel soo dry.... now as I 'tested it out' I spent a couple hours on the computer ... and my eyes stay significantly 'white'... and don't feel as dry... basically its not bothersome to use the computer now
I may never get casper white eyes like some people I know... but it is a helluva lot better looking than before.. I can now say I don't look like I just smoked a toke.
- I still take flaxseed capsules, as I think it will help and has been helping me even more (produce 'good quality tears')
- I'm veering off the FML steroid eye drops... and i'm still good
- EYE DROPS ARE SOOO MUCH Less needed now... I find that I use them mainly to ''wash out'' my eyes... I might need 2 drops a day now... and I could still manage with none
- i'm glad I got them...
-CAVEATS:
Even though they are 'permanent' they can still pop out... so I would get an optometrist to check if theyre still in...
-At first you can experience over-tearing or 'epiphora' but for me that went away the first week, but it can still randomly come...
-You get more EYE boogers more (just look in the mirror more and wipe them off with a q-tip)
**THE ACTUAL PROCEDURE**
for the lower perm. plugs...it was a more less invasive feeling procedure... I was in a chair sitting and I felt fine when it was all done in a matter of a minute or so
for the uppers... i lied down on the same surgical bed as the lasik surgery, unbenounced to me...
and more invasive feeling....had alot of eye pressure during the procedure (5-8 minutes for me), like the doc was pushing down on my eyeballs, that was the feeling
and alot of annoyance after....
For the first few days after the procedure it was bad... and i was questioning if I made the right choice... because my eyes (inner corner) weere REAAAALLLY RED like opaque red and veiny... my eyes still had that pressured feeling and overall Uncomfortable-ness!
that all went away in a week and all of that post-redness fully gone within 2 weeks...redness went down by the 1st week though
Hope that helped!
and I hope you can find relief...
the uppers were a last resort (on a medical/clinical/surgical level and personal level) and i'm glad i got it done.
** Side-note: Lasik made my eyes light-sensitive.... punctal plugs had no effect in that unfortunately
crap this is long! sorry i wanted to keep it short
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Tankie
Dry Eye Patient
Join Date: Aug 2010
Posts: 254
#1
Free Lipiflow (sort of) and Punctal Plugs Overcame my Dry Eyes
13-Feb-2015, 20:14
Hi everyone,
I haven't been around in a long time since I am no longer struggling with my dry eyes. I do still have the problem, but it is very manageable, I don't take any drops ever, and I've been working successfully as a teacher for over 2 years. I am now 28 years old. I started with my dry eyes when I was 20, and I didn't overcome them until I was 26. So how did it do it?
1. Hot compresses never worked for me. The towel would get too hot, too cold, I'd burn myself, or I'd get the temperature just right but only for a few seconds and then it would cool off. Standing under the hot shower spray with my eyes closed never seem to get the job done either. However, what did work was buying a space heater that sprays out hot air on my face. Here is the one that I bought: http://www.canadiantire.ca/en/pdp/li...l#.VN6SQ_nF_II. For what it's worth, this will only heat a very small room, but that's not what you are buying it for. For me, I would lie down in front of it with my eyes closed for 10 minutes every morning when I would wake up. While doing so, I would also do blinking exercises and sometimes use my fingers to help excrete the oil out of my glands. This is the only treatment I do for my eyes to this day. I also use my car radiator for this, where I will turn the heat up to the max, aim the vents at my face, and melt the oil while driving. I know that might sound a little scary, but I don't take my focus off the road for even a second and it works really well. However, for the driving version of this, I do it with my eyes open. I also do the blinking exercises and sometimes use my fingers to excrete the oil out of the glands. Feel free to do this for over 10 minutes if you feel that 10 minutes isn't long enough and it is helping. By the way, this is what I meant by "free lipiflow" because all lipiflow is is a device that melts the oil for 12 minutes non stop, and then they will charge you $750 per eye. The option I present here does the same thing, it's free, and you can do it to your heart's content.
2. Punctal plugs: to this day I still have my lower punctal plugs in. Before I discovered what I just mentioned with the space heater and melting the oil, I tried plugging all 4 ducts, but all that lead to was tear overflow and getting a rash around my eyes due to wiping away the tears all day long. It cured the problem since there were so many tears in my eyes, but the rash was very painful itself and I had to do something about it. I then tried leaving my lower plugs in, but putting flow controller plugs (punctal plugs with holes in the middle) in my upper ducts to control the amount of tears that could drain away while keeping some of them in the eye, but I still had the overflow problem with this and so I had them removed. After this, I discovered the space heater method, and since I still had my lower plugs in and they weren't bothering me, I've decided to keep them to this day.
3. I realize that this is not a religious forum, so I'll keep this comment brief but I am a Christian and I believe that drawing near to God played a large part in me getting over the dry eyes. I'll just leave it at that, and I hope this comment doesn't offend anyone.
All in all, I recommend anyone with dry eyes to try my space heater method and getting all 4 punctal plugs put in, and then if you have the overflow problem, get the top ones removed. One major word of caution is that I've had punctal plugs put in by 4 doctors in my time, and 2 out of the 4 doctors did a terrible job of inserting them and they fell out by the time I got home. The way to check if the plugs are actually still inserted, is to look at the inside of your eye and search for a black dot. If you see the black dot, it means there is no plug there since that's the normal drainage duct. If you see a little white plastic plug there, that is good since it means the plug is in. You can observe the black dot (or white plug) in both your lower and upper punctum if you pull your eyelid back.
Good luck everyone, I hope this helps you all and that this will be the thing that turns your life around!
Tankie
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willwork4tears
Dry Eye Patient
- Join Date: Dec 2009
- Posts: 201
#1
I'm baaaaack!
06-Apr-2012, 14:46
Sorry for the lengthy hiatus from participating in the DEZ. I feel bad that I haven't been on in close to a year but I'm going to try to get on here and there.
The good news is that one of the reasons I've been away is that I haven't needed the DEZ as much for advice on my dry eyes because I'm doing much better. I had lower punctal cautery in September 2010 and started using Lacriserts shortly thereafter and this combination along with the 1% cyclosporine I had been using for a while has been a life changer!
Of course, for those of you that know me, you know I have Sjogren's, so I'm still dealing with all those issues as well. Life is not perfect, but at least I don't feel like clawing my dry/gritty/sore eyes out of my eyesockets any longer!
But I still want to be around to be a support to others. So I'll try not to be such a stranger.
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SunshineinCalgary
Dry Eye Patient
- Join Date: Mar 2012
- Posts: 60
#8
15-May-2012, 21:51
Ladiva,
I guess I must be lucky "in some way". I have permanent plugs inserted (lower ones for 8 years and upper ones for a year) As a matter of fact, I don't even know my lower ones were there until my optometrist told me. I guess the success of plugs depends very much on your eye specialist. I know some didn't want to do the plugs as they had little experience doing them. My specialist was very good in doing plugs, that seems to be his expertise !!!
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glenda
Dry Eye Patient
- Join Date: May 2012
- Posts: 26
#13
03-Jun-2012, 14:21
I had plugs put in on May 28. The first day I could feel the one in my left eye, but the 2nd day, I could not feel anything. I do not know which kind I have, all I know is that they are a different size in each eye. (mine are lower plugs) I think they are umbrella, as when I pull my lower lash lid down, I can see a white top. Otherwise, I would never know they were there. They have helped. I am not pouring the drops in every 45 minutes. Sometimes I can go 2 hours without putting in drops. Over night I put in liposic around 9pm and when I wake at 8, there is no gunk on my lids and my eyes are not dry.
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kanon
Dry Eye Patient
- Join Date: May 2012
- Posts: 67
#2
04-Jun-2012, 07:45
Hi Dave,
Years ago I had my upper puncta cauterized (plugs kept coming out) and that made my eyes great! Really helped my dry eyes. My eyes became a little "too teary" but this was ok for me since it was SO much better than the misery of the dry eyes. (Now, years later, I am considering having my lowers cauterized as well, since my eyes got messed up recently from a bout with conjunctivitis...Have had plugs put in the lowers 3 times in the last month and they keep coming out. Want to get them cauterized, but then I would have 4 cauterized puncta, and that permanence sort of scares me....)
You posted on May 21, did you make a decision yet about cauterization? Ashley
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PAllen
Dry Eye Patient
- Join Date: Feb 2011
- Posts: 55
#3
19-Mar-2012, 20:44
Yes. The relief they gave me was instant. I did have to get all 4 done. Just the lowers didn't do much. I had the plugs fall out lots of times. a couple ended up in the corner of my eye, but they're soft and pliable and I just took them out.
good luck, Jen.
needhelp640
Dry Eye Patient
- Join Date: Dec 2010
- Posts: 24
#2
19-Mar-2012, 19:40
Hey there,
You should go forward with it. Plugs have helped me a lot and they should help you with ur RCEs. If your afraid of them falling into your eye then you cam get temporary intracranular ones that sit inside your sinuses, dont really move anywhere and get absorbed by your body in about a month. It would also help you decide whether or not to get silicone semipermanent plugs
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SAAG
Dry Eye Patient
- Join Date: May 2009
- Posts: 1604
#10
22-Jan-2013, 20:12
Originally posted by patientpatrick View Post
Saag PCL is apparently the material the extended temp ones are.
Ok... well sounds like those may be similar to the kind of temp. plugs I had - mine were the kind of temp plugs that are supposed to slowly dissolve over 3 months. Also, I had those 3-mo temp. plugs in all 4 puncta at one point and I had no overflow.
However, with permanent umbrella-style silicone plugs in my lowers, and uppers cauterized (as long as they stay shut haha), I definitely have overflow and it totally rocks compared to being so dry.
So, moral of the story is.... try the permanent ones and odds are good they'll be even BETTER than the temps are at 100% blocking your puncta.... so there's still hope for you to get overflow... no worries!
And as others have said, even overflow is not always a perfect solution since if you don't have enough lipids in your tear film, the tears may still evaporate too fast... but still, a lot of people are way more comfy with overflow compared to not, so I say give the permanent plugs a try! Plus, it's possible that with some of the aqueous deficiency relieved, there may be less inflammation on your ocular surface, which may end up leading to less inflammation in your meibomian glands and improved meibomian gland function... again, you won't know if you'll fit this profile unless you try, right? (Not saying that plugs can't worsen MGD too... but not everyone is the same)
Keep in mind that some docs may hesitate saying something along the lines of "well, if the temps didn't help much, then no point in trying permanant ones". I'd respond to that by saying that you don't know unless you try and there are many reports of people finding the permanents doing a better job of fully blocking the puncta... PLUS, if the permanents don't help, you can always have them removed so it's not like you can't back out later... I can't emphasize enough the fact that you have to at least TRY to see how YOU react to them.
Originally posted by patientpatrick View Post
I'm debating whether to just give up on them or pursue the permanent ones. I'm still quite confused since the temps seemed rather ineffective.
No offense, I'm going to be blunt here... please take this in the nicest possible way I see no logical reason NOT to try the permanent ones since ...
a) you noticed "a bit" of improvement with the temps (that could be a sign of good things to come with permanent ones!!!)
b) there have been tons of people on these forums over the years who can vouch for the fact that permanent umbrella plugs worked better for them than temps (if I recall correctly, my own doctor even noticed this in some of his patients... so there is another source of that info)
c) the permanent plugs do not have to be permanent, so if the end up causing more negatives than positives for you, it's easy to get them removed
d) you have no way of knowing for sure whether or not permanent umbrella plugs will help you unless you TRY them... so do it!!!
farmgirl
Dry Eye Patient
- Join Date: Mar 2012
- Posts: 542
#22
22-Jan-2013, 23:33
OK, for what it's worth I gotta add my two bits. I had temporaries in all 4, that helped. I got the uppers cauterized and umbrella plugs in the lowers, that helped a LOT. The lower right came out twice so since I didn't have time to get a custom fit one put in I had a longer lasting temporary put in. Now that eye bothers me somewhat where the left doesn't and I know that it isn't plugged as well since at times I can taste my restasis in the back of my throat. Moral of this story is, like SAAG says temporary plugs don't work as well as permanent removable plugs.
At times I get a wee bit of overflow on the left which I don't mind but sometimes the eyelid gets a bit sore from the salt off of my fingers when I wipe it away so I need to resort to carrying a tissue to keep my fingers off of the lid. Hope you find more relied with permanents and I highly recommend you try them...cheers...F/G
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Shahara
Dry Eye Patient
- Join Date: Jun 2007
- Posts: 78
#1
Almost no dry eye now...
19-Dec-2011, 16:57
I was here regularly sometime back. But I thought I should just peep in here to see wots going on.... ( I live in germany!)
My dry eye began somewhere around 2002 I guess. I use to live a very unhealthy lifestyle, ate loads of sugar and I hardly ever ate any vegetables or fruits in my teens.
My dry eye got so extremely worst somewhere around 2004/2005 that I had to use drops almost every half and hour. I was stuck at home unable to go out due to the severe dryness. I was suffering from depression and was looking tired and sick 24/7.
After seeing many ophthalmogists but without any useable help. Somewhere around 2006/2007 I got plugs and restasis. Plugs fell out many times so my eye doc closed my upper tear ducts (What is the english definition for that?)
I took restasis for a while but was scared about long time sideaffects. After a long time suffering I decided to go to an alternative practitioner. As I took antibiotics for a very long time he asked me to get the intestinal repair with detoxing measures and a systematic propogation of the gut flora, which suffer damage from antibiotics. I took natural bacterias in form of drops and powder for a long time. My dryness was slowly disapearing.
Now I hardly ever take any eyedrops. I hope this might help someone...
Thank you
Shahara
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ryanross
Dry Eye Patient
- Join Date: Sep 2010
- Posts: 36
#2
10-Nov-2011, 18:52
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.
tearless2
Dry Eye Patient
- Join Date: Apr 2010
- Posts: 153
#10
15-Nov-2011, 23:20
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.
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PRK
Dry Eye Patient
- Join Date: Mar 2011
- Posts: 51
#1
6 years after PRK dry eye mostly gone with two punctal plugs
06-Nov-2017, 14:31
It’s been almost 6 years since I had PRK and my eyes are feeling good. I used to have four punctal plugs but two of them fell out probably 4-5 years ago and I waited to see if I could get by without them. So now I just have two plugs, one in each eye. I have a .5mm Eaglevison Superflex plug in the lower tear duct of my left eye and a .6mm Superflex plug in my upper right eye. I don’t really notice them and they have never really given me any trouble. My eyes are pretty normal nowadays and I haven’t really had any major problems for years. My eyes still get a little dry when I’m sleeping but most nights it’s not really noticeable. Every 2-4 months I do get a night where my eyelids stick to my eyes a little and that can cause some pain for a few minutes sometimes but then my eyes start to water and it goes away. They can still get a little dry if I’m doing dusty yard work or stay up really late. I don’t have drippy eyes like I did with four plugs but that wasn’t all that bad anyways. I haven’t used drops of any kind for years. If my eyes get a little dry I just close my eyes and while they are closed I squeeze my eyes shut a few times like I’m yawning to get my lacrimal glands to release some tears. Also if I pretend to yawn a few times I can usually encourage a real yawn which makes my eyes water. Anyways that’s pretty much all I have for an update. Hope everyone is doing well.
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indrep
Moderator
- Join Date: Feb 2006
- Posts: 818
#9
05-Oct-2012, 06:59
Having been around punctal plugs for 27 years I could write till everyone went to sleep like Rip Van Winkle.
The best plug is the plug that works best for the individual. Having said that there are some plugs that are more prone to problems. Primarily avoid intracanalicular plugs of the long term variety if at all possible. However there is an option available that does not have the same reported issues as the other types. Also hard silicone plugs tend to create more problems than soft silicone plugs. Plugs with designs of the anchor that can create pressure points also tend to have more reported problems.
Also some problems occur when the insertion technique might not be as good as it can be. This tends to happen with temporary plugs that have less than polished edges.
Having said all of that my wife has been plugged with various plugs for 20 years, the most recent almost 9 years ago with intracanalicular plugs. Punctal plugs have helped a great many people over the years and the vast majority of problems could be avoided if the proper plug was chosen and the proper technique used for insertion.
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indrep
Moderator
- Join Date: Feb 2006
- Posts: 818
#11
06-Jun-2011, 17:20
I would look for a plug that has a continuous anchor and neck. Something that eliminates pressure points. The more surface area that tissue touches the less likelihood there is of irritation to the skin leading to an inflammatory response.
A study from a group in Iowa, can't remember name (17 years ago), measured puncta using the EagleVision gauge (most popular) and found 40% of puncta measured .6, 30% - .5, 20% - .7 and 5% each for .4 and .8. It also showed that 30% of the patients had different size puncta.
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MBC
Dry Eye Patient
- Join Date: Jan 2011
- Posts: 38
#6
16-Mar-2011, 10:53
I have had plugs for a year and they really help a lot. The problem is that they keep falling out and I had them replaced about 7 times already. They have different sizes and they are difficult to fit. However if you can get someone who really cares about fitting them correctly I think you will find they help very much. You have to be careful not to rub your eyes because you can rub them right out of your eyes. It does not hurt to get them put in
Rick0517
Dry Eye Patient
- Join Date: Apr 2010
- Posts: 3
#8
19-Mar-2011, 11:46
Punctal Plugs
Thanks to everyone that replied. You have sent me some very good and important info. I am currently trying the 7 day temporary plugs and now on day 4 without any problems. They seem to extend the time between using eye wetting drops by as much as 4 hours! I'm not experiencing any uncomfortableness at all which is a welcome surprise. Still having burning with certain brands of drops and my glaucoma meds though. Next week I'll try the 3 month temporary plugs, if my insurance covers it. I didn't think to check( gibbet - extra thanks for that suggestion! ). I'm trying to avoid getting the gold weight in my eye lid for now but that may be necessary eventually.
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djeanwithdryeyes
Dry Eye Patient
- Join Date: Dec 2010
- Posts: 38
#6
10-Dec-2010, 18:30
new to plugs
I was having DES problems and the doctor wanted me to try plugs. I read the mixed results here on this website. So I wouldn't do it! Eye pain got worse so I finally agreed to bottom to be plugged with 3 months Oasis. The doctor showed me, the plugs are blue foam like plugs and the plugs are installed into the tear duct, so no one can see them. The plugs form fit to the tear duct, expand in 10 minutes to fit.
On Thursday, Nov. 9th - I had the top plugged.
As for me, there has been a good change.
To be honest, I am still NOT thrilled about the thought of having something artificial stuck in my tear ducts but my eyes do seem better!
Anyway, so far so good!
mjf79
Dry Eye Patient
- Join Date: Jan 2009
- Posts: 62
#7
02-Feb-2011, 22:46
I have traditional plugs put in, but my newest doctor buried them further in to where no part of the plug touches my eye. My tear duct sits angled in more than other people's, so when the first doctor put them in they scratched my eyes and caused major problems. He tried 3 different times with different sizes. The new doctor I go to simply buried them further in and I've had them for 2 years with no problems. If I need them out he will simply flush them out. I had him do this once to see if plugs were creating an increase in itching. Well, they were, but I take the itching over the pain of the dryness without the plugs. I use an allergy/anti-itch drop on days that my eyes are itchy.
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LasikEyes
DryEyeTalk Newbie
- Join Date: Sep 2012
- Posts: 1
#1
4 PUNCTAL PLUGS + and I'm BETTER
09-Oct-2012, 06:09
...... I wanted to share my experience with all of you because I know how $hit daily life can be when you have dry eyes, no one understands and takes you seriously ... even more annoying
Mini HISTORY Lesson:
-Wore Contact Lenses since I was 12... (noticed I had dry eye since whenever I wore them = veiny reddish @ inner corners)
-Had the ''Custom-Wave Front" Lasik Surgery done at 19 ... (turning 22)........ made eyes even MORE DRY-ER and only feeling worse as months go by= imagine feeling like you have a contact lense in your eye you slept with all night, all week perhaps, constantly having that feeling as if a MINI-FAN was blowing in your face...and there is no wind near! ... or even worse somedays... feeling as if you swam wide-eyed in a chlorine pool with your dirty contact lense and whilst having the mini-fan blow in your face.......(o yea red veiny eyes= STONED LOOK, because of the pain of your eyes u can barely keep them open normally)...........NEED I SAY MORE!!!??? uuuuuuuaghhh !!!
THINGS I TRIED BEFORE -HAND
- So I've read about warm compresses and even an optometrist told me to do so...BUT I've tried WARM and (ICE)-COLD... I've found ICE-cold feels more soothing and decreases redness way more! ( just a handful of ice+water + face towel)
-REDNESS-RELIEVER Eye drops.... *i'm telling u...DONT depend on these! I suggest u stay away from these altogether anyway they are TEMPORARY and will only make u worse and feeling more dry even more if u over-use, for relief stick to lubricant drops only!!
-LUBRICANT DROPS/ EYE DROPS
After testing a couple of staple brands... I always ended up buying GENTEAL...(liquid/gel drops)... still I was going through a bottle every 2 weeks @ $12 a bottle...8 drops a day or so
-MEDICATION
5 month run of accutane 40 mg (10 mg off and on), it is said to induce dry eye
-SUPPLEMENTS
I Know for sure that the ''NATURE'S BOUNTY'' Flaxseed Oil Capsules
http://www.drugstore.com/natures-bou...2?catid=183250
I started to take in 2011 helped me with dryness and thus a tad lessened some redness, noticeably enough..... but not completely satisfied to stop looking for solutions
ALSO I ditched the flaxseed for 2 months to try the EXPENSIVE ''PRN'' DRY EYE OMEGA Benefit pills ''Physician Recommended"........ but I saw no major difference... and think nature's bounty is better anyway
Also tried ''THERA TEARS fish oil capsules''.... again i would still choose nature's bounty flaxseed
PUNCTAL PLUGS + short run on FML drops:
-@ first tried TEMPORARY PUNCTAL PLUGS
didnt notice much of a difference
for the 3 months it was supposedly to last there
-*** WENT TO A DRY EYE STUDY***, where obviously I qualified the UN-BIASED DOC there noted that I indEED have very dry eyes, where he preformed tests on me...(i.e- schirmer test, where it revealed I didn't produce enough tears... NORMAL people tears get a 11-15 count..whereas I got 1-3 count)
- PERMANENT LOWER PLUGS + PRESCRIPTION STEROID (FML) Drops
found noticeable relief with lessened red veiny eyes,,I was also prescribed FML eye drops that I was using ,,, but still I wanted more moisture!
-FINALLLY (after much personal research)....GOT UPPER PERMANENT PLUGGED as well !
-so now I am quad-plugged ... initially the LASIK Surgeon and optometrist said I don't NEED uppers done.. but once I told the surgeon that it's been nearly 3 years later and just how many bottles of i-drops I use he gave in ...... There at LASIK they don't and have never BOTHERED to do any formal tests on me like (the schirmer's test, and tear break up test etc)...they just look at my cornea in there handy dandy microscope and see I have no 'dry spots'... welll isn't that just LAZY-NEGLECTful, dumb-of-them since... dry eyes can be an aqueous deficiency !
-VERDICT
I feel much better ... REDNESS Noticeably Lessened! .. although the veins haven't disappeared, it has just subsided and the pigment of what is now pinkish (not red) has gone done alot! i know for sure because before if I spent just 30 minutes on the computer my eyes would get soo red and feel soo dry.... now as I 'tested it out' I spent a couple hours on the computer ... and my eyes stay significantly 'white'... and don't feel as dry... basically its not bothersome to use the computer now
I may never get casper white eyes like some people I know... but it is a helluva lot better looking than before.. I can now say I don't look like I just smoked a toke.
- I still take flaxseed capsules, as I think it will help and has been helping me even more (produce 'good quality tears')
- I'm veering off the FML steroid eye drops... and i'm still good
- EYE DROPS ARE SOOO MUCH Less needed now... I find that I use them mainly to ''wash out'' my eyes... I might need 2 drops a day now... and I could still manage with none
- i'm glad I got them...
-CAVEATS:
Even though they are 'permanent' they can still pop out... so I would get an optometrist to check if theyre still in...
-At first you can experience over-tearing or 'epiphora' but for me that went away the first week, but it can still randomly come...
-You get more EYE boogers more (just look in the mirror more and wipe them off with a q-tip)
**THE ACTUAL PROCEDURE**
for the lower perm. plugs...it was a more less invasive feeling procedure... I was in a chair sitting and I felt fine when it was all done in a matter of a minute or so
for the uppers... i lied down on the same surgical bed as the lasik surgery, unbenounced to me...
and more invasive feeling....had alot of eye pressure during the procedure (5-8 minutes for me), like the doc was pushing down on my eyeballs, that was the feeling
and alot of annoyance after....
For the first few days after the procedure it was bad... and i was questioning if I made the right choice... because my eyes (inner corner) weere REAAAALLLY RED like opaque red and veiny... my eyes still had that pressured feeling and overall Uncomfortable-ness!
that all went away in a week and all of that post-redness fully gone within 2 weeks...redness went down by the 1st week though
Hope that helped!
and I hope you can find relief...
the uppers were a last resort (on a medical/clinical/surgical level and personal level) and i'm glad i got it done.
** Side-note: Lasik made my eyes light-sensitive.... punctal plugs had no effect in that unfortunately
crap this is long! sorry i wanted to keep it short
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