Plugs / Conjunctivochalasis / Inflammation / Help!

[Guest]

Hi, wondering if anyone can help? - I was silicone plugged in my lower ducts only for the first time 2 and a half weeks ago. Initially I was told by a dry eye specialist that I have T cells under the lids and a short strong course of steroids was recommended before moving onto plugs and restasis. For various reasons I wasn't able to start the steroids straight away. I've now seen a local corneal specialist who said no need to treat the inflammation as the eyes aren't red and he 'wasn't bothered' by the conjunctivochalasis and said just get the plugs in, hot compresses for 2 months and he will then check for improvement and think about possible doxy and restasis. I am bothered by the chalasis because I didn't have it at all 18 months ago and it seems to have suddenly got worse in the last 6 months, it's at the outsides of my corneas. My eyes still look white but there is a sort of jellyish / moist looking effect in the corners of my eyes which makes them look quite glistening and watery even though they're dry as a bone most of the time and if I look to the far side it forms a fold in each eye. Since having the plugs put in I have had a couple of mornings where the inside of the cornea has had the same effect, so it seems to have made things worse (I also think the outsides are worse for more of the time). The plugs do at least keep drops on the eye a bit longer but there's not a massive amount of improvement overall. I have between 0 and 2 on a Schirmer, lid margin disease, rosacea. Should the inflammation have been treated first? Would it be ok to use strong steroids with the plugs in or does it really have to be before they go in and also, I have read that plugging can made the chalasis worse - this may be my biggest worry because it seems to be getting worse so much worse recently and I don't want to do something which will add to it. Given the plugs don't do a massive amount without restasis, should I just have them removed, one is scratching anyway? Thanks for any replies.

[Almondiyz]

Sometimes plugs are inserted even with inflammation to keep eye medications in the eye longer. I had lower plugs inserted when my blepharitis, meibomian gland dysfunction & ocular rosacea were severe January 25, 2014.

Did the plugs just pop in without the doctor having to dilate the puncta? I had to have my puncta dilated (she poked a needle looking thing in to enlarge both puncta; a tiny bit of blood resulted.)

I was prescribed Erthroymicin ointment for 7 days afterwards. I was already on Doxycycline 50 mg once daily that was increased to twice daily.

I do recall the first month I had the sensation of the plugs scratching my eyes. My doctor had me comeback in 3 days, then 7 days. I go back March 18, 2014.

The main reason for the frequency of follow up visits are because I complained of irritation of that the plugs felt like they were scratching the inner surface area of both my eyes, the left being worse. I have a history of corneal abrasions & having to wear bandage contact lenses, another reason why the frequent evaluations.

I think the pain make us feel so HELPLESS, HOPELESS, & DESPERATE for any relief that we try everything that can be prescribed. For me, I still get caught up in the desperation to try new things. Yet, it always seems that all the STUFF I use in my eyes end up irritating or damaging my eyes more. Common sense evades me during the severe episodes & even knowing better that MORE STUFF ISN'T the answer, I'm still looking for the magic potion that for me, I haven't been able to have prescribed.

I'm sort of talking to myself right now...I do realize that when I'm not as DESPERATE which leads to PANIC, the LESS I do to my eyes, the better they feel. When I mix up so many medications & treatments, I really can't tell what's making my eyes worse.

[Guest]

Sometimes plugs are inserted even with inflammation to keep eye medications in the eye longer. I had lower plugs inserted when my blepharitis, meibomian gland dysfunction & ocular rosacea were severe January 25, 2014.

Did the plugs just pop in without the doctor having to dilate the puncta? I had to have my puncta dilated (she poked a needle looking thing in to enlarge both puncta; a tiny bit of blood resulted.)

I was prescribed Erthroymicin ointment for 7 days afterwards. I was already on Doxycycline 50 mg once daily that was increased to twice daily.

I do recall the first month I had the sensation of the plugs scratching my eyes. My doctor had me comeback in 3 days, then 7 days. I go back March 18, 2014.

The main reason for the frequency of follow up visits are because I complained of irritation of that the plugs felt like they were scratching the inner surface area of both my eyes, the left being worse. I have a history of corneal abrasions & having to wear bandage contact lenses, another reason why the frequent evaluations.

I think the pain make us feel so HELPLESS, HOPELESS, & DESPERATE for any relief that we try everything that can be prescribed. For me, I still get caught up in the desperation to try new things. Yet, it always seems that all the STUFF I use in my eyes end up irritating or damaging my eyes more. Common sense evades me during the severe episodes & even knowing better that MORE STUFF ISN'T the answer, I'm still looking for the magic potion that for me, I haven't been able to have prescribed.

I'm sort of talking to myself right now...I do realize that when I'm not as DESPERATE which leads to PANIC, the LESS I do to my eyes, the better they feel. When I mix up so many medications & treatments, I really can't tell what's making my eyes worse.

Hi Almondiyz

Thanks for replying, no they didn't stretch my puncta thank goodness. I have now had the plugs taken out though as they were getting more irritating and my right eye had gone red in the corner but I think they (well one) were slightly helpful in keeping a bit of moisture on the eye so hopefully I will have it done again with a different type of plug once I've been re-referred. I know what you mean about not knowing whether it's better to do more or less to try and help the situation. There's still things I haven't tried so going to use a balance of instinct and research and if anything's making it worse I'll stop. I really hope you find something that helps your eyes soon!!

[glimmer-of-hope]

I will have it done again with a different type of plug once I've been re-referred.

I hope you don’t mean SmartPlugs!!! Their name is definitely not right cause they are not smart at all!!! They won’t scratch your eyes like the other type of plugs (that’s probably the only advantage) because they are inserted somewhere in your ducts and then almost impossible to extract (even with surgery) in case of infection which happens often with SmartPlugs!!! There are many doctors who know about this problem and they don’t insert these plugs anymore because it’s just not worth the risk! But many doctors still use these plugs…

Here you can find some more info about SmartPlugs and why smart doctors won’t use them:

http://www.revophth.com/content/d/fe.../1448/c/27348/

http://www.eyeworld.org/article.php?sid=4909

And here on the forum:

http://www.dryeyezone.com/talk/showt...om-Smart-Plugs

[Jade]

Almondiyz,
What you wrote about helpless, hopeless, and panic is exactly what I've been going through for years trying to get better.
I could've wrote it myself.

[Almondiyz]

Almondiyz,
What you wrote about helpless, hopeless, and panic is exactly what I've been going through for years trying to get better.
I could've wrote it myself.

Jade,
How do you cope? TODAY, March 7, 2014 marks ONE YEAR of this Abyss of helplessness, hopelessness that lead to PANIC. I say & think terrible things about my eyes when I'm in a state of pain, suffering & panic. It really doesn't help me to talk with my psychiatrist. people just don't understand unless they suffer a similar situation. Today, of all days, my birthday, is only about my eyes & how terrible I feel. My husband & son tells me to "cheer up." HOW can i cheer up, STOP THINKING/OBSESSING about my eyes when everywhere I look in the house, the car, my purse...everything has STUFF for my eyes? Sorry to go on a rant. I'm just very anxious & depressed today.

[Jade]

Aldondiyz
One day at a time. I recently had a treatment that was supposed to help my eyes a lot and so far I'm much worse.
My dr isn't being supportive. I'm scared to death. Pain is a horrible thing.
I feel for you on your birthday and trying to just be a normal person. I get some calm when I read other peoples' stories on this website that prove I'm not alone at least in cyberspace.