Punctual Plugs? (Vs Lipiflow/IPL)

[PRK]

I agree with farmgirl. I didn’'t notice much of a difference with just the lower 2 plugs it took 4 to feel a difference. After that my eyes were more on the wet side but it was much more manageable than dry eye. Getting plugs is a lot like buying a pair of shoes, you need a pair that fit you. Otherwise it’'s like saying I tried on some shoes and they were uncomfortable so shoes don’'t work for me.

I tried 3 different plug sizes before I ended up the ones I have now. The plugs I had that were too large were scratchy and would fall out after a few weeks or months. You want the smallest plug that will fit in your punctum since the cap will sit lower, not rub against the eye and eventually fall out.

http://forum.dryeyezone.com/forum/dr...gs-have-helped

[farmgirl]

I am aqueous deficient and have MGD so plugs were a lifesaver for me, I will never be without to the point that I had the uppers cauterized permanently. Obviously I have inflammation that is part and parcel of the syndrome but the plugs have never, to my knowledge, created a problem for me. There is such a thing as toxic tears and it is related to inflammation as discussed in this article. However for me it comes down to symptoms and I can tell you that I am much worse without plugs than with, toxic tears or no.

If you feel better leave them in, if you don't take them out, bearing in mind that 2 didn't cut it for me I needed all 4 plugged to feel the difference.

https://www.healio.com/optometry/cor...e-inflammation

[Glucoa]

For myself, punctal plugs greatly improve my overall eye comfort and increase the time between when I feel the need to put in more eye drops. When I have all four puncta plugged, I tend to occasionally have tears run down the side of my nose, but the nuisance is sure better than feeling extra dry all the time.

My upper left plug actually fell out a few weeks ago and I ended up getting a minor corneal abrasion a few days after during the night. The difference with and without the plugs is pretty noticeable for myself.

And yes, if you still feel the plugs scratching your eye when you blink after having them in for a day or two, you should go back to your eye doctor to have them push them in farther or swap out the plugs for a different brand or size that better fits with your puncta.

[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.

[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.

[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?

[Hokucat]

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

[Kabuto]

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

[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.

[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]

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.

[Kabuto]

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

[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!

[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.

[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.