Punctual Plugs? (Vs Lipiflow/IPL)

[Kabuto]

Hi all!

What is everyones opinion on Punctal Plugs? Are they valuable? Helpful? Safe? I really don’t know much about them.

[Meibum Ian]

It depends on the nature of your dry eye.

Lipiflow / IPL are used to improve meibomian gland function. Plugs are typically used to address aqueous deficiency.

Plugs are often advised against when inflammation is present, to prevent pooling of inflammatory tears on the eye.

You need a good doctor to advise on the nature of your problem and to guide you in the best course of action.

[deep_dry_eye]

It depends on the nature of your dry eye.

Lipiflow / IPL are used to improve meibomian gland function. Plugs are typically used to address aqueous deficiency.

Plugs are often advised against when inflammation is present, to prevent pooling of inflammatory tears on the eye.

You need a good doctor to advise on the nature of your problem and to guide you in the best course of action.

Agreed. Plugs didn't help me at all. Plugs at most will help the symptoms of your problem, however it doesn't tackle the underlying cause of the disease. IPL / LipiFlow has a higher chance of fixng the underlying cause (remove blockages and/or reduce inflammation).

[Kabuto]

I was diagnosed with Meibomian Gland Dysfunction

Wow. My doctor this morning recommended punctal plugs (and even put them in for me, they’re in as we speak)

But then another doctor I saw before said she recommended Lipiflow.

Not sure what to believe anymore.

[deep_dry_eye]

I was diagnosed with Meibomian Gland Dysfunction

Wow. My doctor this morning recommended punctal plugs (and even put them in for me, they’re in as we speak)

But then another doctor I saw before said she recommended Lipiflow.

Not sure what to believe anymore.

My personal opinion is do LipiFlow + IPL + get yourself on anti-inflammatory drugs such as azithromycin + restasis + xiidra.

Punctual plugs may help your symptoms but not the underlying disease. Punctual plugs won't help your MG glands.

[Hokucat]

Yes, punctual plugs only address the symptoms, however if it helps some, feeling better is just as important. Ususally its a typical initial treatment even for those with MGD since it’s easy to do and relatively inexpensive. Did you just get lowers, or also uppers? Some in this forum have found having both at the same time helpful, as opposed to only lowers.

Earlier in my dry eye journey, I tried lowers. I have both MGD and aqueous deficiency, For a few weeks my eyes felt much better, but then it didin’t seem to help anymore. I’ve also tried both at the same time (temporary dissolving uppers), but adding the uppers gave my eyes a weird unpleasant feeling.

I still have dry eyes, but not as severe now. But last year I noticed my left eye was feeling a little drier for few weeks, and sure enough, the lower plug was gone. When I got another one, it felt.better. Plugs are not THE solution at all for me, but it’s something that helps a little, and when one has dry eyes, every little bit counts!

[Kabuto]

Well, my doc already put the punctal plugs in.... Should I get them taken out??

[Hokucat]

Keep them in and see if it helps. The only reason to remove them is if they are causing irritation or making your eyes feel worse. I’ve had lowers for 9 years now.

[Meibum Ian]

I don't quite get the criticism of plugs only affecting symptoms

Presence of tears is important to the eye's health, preventing corneal damage and resultant inflammation / worsening of dry eye.

[Hokucat]

Likely since plugs do not make the lacrimal or meibomian glands work better, that’s why it’s not considered to address the cause, and rather the symptoms from disfunctional glands. But totally agree it’s important to help prevent corneal damage whether it be with plugs, sclerals, prokera, artificial tears, etc.

[Kabuto]

So what does help the symptoms improve? Lipiflow/IPL?

[Hokucat]

If LipiFlow and/or IPL help your underlying cause, theoretically they should also help your symptoms improve.

[Kabuto]

These plugs are annoying me a lot. I really want them out. Is it just me overreacting or is this something I should get removed?

[deep_dry_eye]

These plugs are annoying me a lot. I really want them out. Is it just me overreacting or is this something I should get removed?

This should be inbetween you and your dr. The plugs should fit quite comfortably. When I tried plugs (they didn't help), I could barely feel them.

[hopeful_hiker]

Kabuto punctal plugs helped me but not enough because my primary issue is clogged glands. I have different plugs. Left is intranasal, meaning the tip is not sticking out. The right is capped so I can see it. I can really tell the difference when I got to places with low humidity. The left eye gives out first.

The reason why I got the intranasal plug is because the cap annoyed me. You should not feel your plugs. If you do, they are touching your eyes and you don’’t want that.

I also started IPL and will also do Lipiflow. Punctal plugs are for symptom reduction in my case.