how do you feel when you have permanent silicone umbrella plugs?

[tealeaf]

Dear all,

The previous 1 month, I used temporary dissolvable plugs in lower tear ducts and could feel some improvement in my eyes. As the plugs keep dissolving, I have proceeded to put in permanent silicone plug with cap yesterday.

Question here is that I feel my eyes drier than before the plugs ... is it still early days? When I had temporary plugs, within 24 hours, I felt my eyes more comfortable (though not a lot but I could feel some improvement), but with this permanent ones, I feel drier and have menthol sensation. Is it because the eyes are still adjusting to the cap (There was abrasion in my eyes yesterday but today, abrasion is much lesser)? Anybody has issue with this? I also feel a bit of itch near the area of tear ducts, it is normal?

My opth. did not measure my tear ducts, she simply put in the smallest plugs (Odyssey Parasol Small - 0.35 to 0.65mm).

Appreciate your kind response. Thanks!

[chella21279]

I have had permanent plugs for about week. They're called smart plugs, which I don't believe have caps. Once they adjust to my body temp it adjusts itself. They're not doing a whole lot but definitely not drying my eyes out more.

[tealeaf]

Hi Chella,
Thanks for your reply. Mine are permanent plugs with cap. Think I need time to adjust to them.
With your plugs for a week, have you reduced on the use of OTC tear drops?

[runnergirl]

Hi Tealeaf,

I too had plugs like yours with a cap. They were weird. I could feel them. However, after a few weeks, I just got used to them and they did not bother me anymore. Then, they fell out and I did not even know they fell out. So I did not replace them. Maybe I will try these smart plugs.

[spmcc]

OMG please read about smart plugs before you get them... you can search DEZ using the term "medennium" (they are the makers of SmartPlugs)

Also, here's a paper from 2011: http://www.revophth.com/content/c/27348/

[tealeaf]

I too had plugs like yours with a cap. They were weird. I could feel them. However, after a few weeks, I just got used to them and they did not bother me anymore. Then, they fell out and I did not even know they fell out.

Runnergirl, the initial weeks of getting used to the plugs, were your eyes around the cap slightly red and itchy?

Maybe I will try these smart plugs.

It is advisable in this forum to use the most conventional permanent silicone plugs with cap as they have the lowest risk. If they are not suitable, can have them removed. Smart plugs have reported complications.

[chella21279]

Hi Chella,
Thanks for your reply. Mine are permanent plugs with cap. Think I need time to adjust to them.
With your plugs for a week, have you reduced on the use of OTC tear drops?

Yes, most definitely. I remember the day before I got the plugs inserted..I could barely see (constant blinking with terribly irritated eyes). The next day I got the plugs inserted and eyes were a lot better. However, I can't say they're taking away all of my misery. I can still feel the dryness and irritation, just not as bad.

With that said, after reading about all the horror stories regarding smart plugs, I will ask to have them removed during my next doctors visit. A few of my friends have been using restasis and told me it works really well so I will definitely give that a shot (hoping I can bare the massive burning).

Good luck with the plugs. It's definitely not for everyone. I not only have evaporative dry eye...I am also not producing enough tears..so plugs aren't really helping much

[tealeaf]

With that said, after reading about all the horror stories regarding smart plugs, I will ask to have them removed during my next doctors visit.

Chella, yes, I think is wise to remove the smart plugs to prevent unnecessary complication in future. Already with dry eyes, we wouldn't want to add more worry.

A few of my friends have been using restasis and told me it works really well so I will definitely give that a shot (hoping I can bare the massive burning).

I have used restasis for 8 months; no burning and is comfortable to my eyes when I put them in, I keep the vial in the fridge.

Good luck with the plugs. It's definitely not for everyone. I not only have evaporative dry eye...I am also not producing enough tears..so plugs aren't really helping much

I have evaporative dry eye plus insufficient tears too. I hope I will get used to the plugs after a few weeks. You may want to do warm compress and lid scrub to help you in the lipid layer to improve evaporative dry eye.

[chella21279]

Chella, yes, I think is wise to remove the smart plugs to prevent unnecessary complication in future. Already with dry eyes, we wouldn't want to add more worry.

I have used restasis for 8 months; no burning and is comfortable to my eyes when I put them in, I keep the vial in the fridge.

I have evaporative dry eye plus insufficient tears too. I hope I will get used to the plugs after a few weeks. You may want to do warm compress and lid scrub to help you in the lipid layer to improve evaporative dry eye.

Thank you so much for the advice! Now I am a bit worried if my doctor will even know if its out, when he does remove it.

Thats great to hear! I will definitely give it a shot. How bad are your dry eyes? Have you done a schirmers? My scores are unfortuantely quite low. 3mm yikes!

Yes, I've been doing the warm compresses as well. Three times a day, 5 minutes each time. Although, I don't know if its helping much either.

[tealeaf]

Hi Chella,
my shirmer test shows 0 mm (R) and 2 mm (L) and TBUT of less than 5 sec for L and 5 to 10 sec for R. My cause of dry eyes is due to Lasik
What is your cause of dry eyes?

I am doing warm compress only once (some how if I do more than once, eye lids feel inflamed even with very low heat. But am doing lid scrub twice a day to get rid of blepharitis. Actually, I am also unsure if the warm compress and lid scrub help, but thought to do it anyway. I suppose if I continue to do for at least half a year, should improve.

What's your TBUT? Do you use eye gel or mask at night to sleep?

[chella21279]

Hi Chella,
my shirmer test shows 0 mm (R) and 2 mm (L) and TBUT of less than 5 sec for L and 5 to 10 sec for R. My cause of dry eyes is due to Lasik
What is your cause of dry eyes?

I am doing warm compress only once (some how if I do more than once, eye lids feel inflamed even with very low heat. But am doing lid scrub twice a day to get rid of blepharitis. Actually, I am also unsure if the warm compress and lid scrub help, but thought to do it anyway. I suppose if I continue to do for at least half a year, should improve.

What's your TBUT? Do you use eye gel or mask at night to sleep?

I'm not sure what caused it. I have another thread asking that question actually. I believe I genetically have dry eye and one day something caused it to flare up. I'm asian and I've spoken to an asian optometrist..and she pretty much emphasized how asians are prone to having DYS

Yes..same for me with the compresses. I don't know if it helps but I do it anyway..in hopes it will help in the near future. I also feel that after the warm compresses my eyes get a bit more irritated. So I try to add a cold compress afterwards (great 5 minute relief lol). I'm also on the lid scrubs for my mgd/bleph as well. Although, I've heard after the lid scrubs, I am supposed to see some of the bleph "crust" on the towel I'm using? But I'm not seeing any so I'm not sure if it's doing much either =\

My TBUT is 2-3 sec for each eye. When my DYS began which was about a month and a half ago..I had a lot of trouble sleeping since I didn't use a gel to sleep. But after I got the plug..it's gotten better where I don't feel the need to use a nighttime gel. My eyes aren't as red and inflamed now and I am able to sleep more than 5 hours a night..hooray! How about you? Are you using a gel/mask for nighttime?

For what it's worth, my ophthalmologist prescribed me an dry eye drop called gum cellulose. I've heard it works wonders. I started it today and it totally took away the irritation in my right eye. Oddly, I can't say it gives me any relief in my left eye so I'm using refresh optive for my left. Are you using any artifical tears?

How long since you've gotten lazik? So is the restasis not completely helping? Hence why you're needing the plugs as well?

My apologies for all the questions. I am relatively new to this whole dry eye issue.

[tealeaf]

Hi Chella,
Yes, I am using vidisic gel and eye mask. I have humidifier in the aircon room too.
My eyes got very dry 1 month post lasik, thus have been troubled by dryness for the past 10 to 11 months

What is gum cellulose? Is it eye drops? I am using systane ultra eye drops and restasis. Restasis helps but to what extend, i have no idea.
Do you intend to have permanent silicone eye plugs?

No worries about the questions, I am also learning and seeking treatment

[chella21279]

Hi Chella,
Yes, I am using vidisic gel and eye mask. I have humidifier in the aircon room too.
My eyes got very dry 1 month post lasik, thus have been troubled by dryness for the past 10 to 11 months

What is gum cellulose? Is it eye drops? I am using systane ultra eye drops and restasis. Restasis helps but to what extend, i have no idea.
Do you intend to have permanent silicone eye plugs?

No worries about the questions, I am also learning and seeking treatment

yes, gum cellulose is a lubricant eye drop similar to an OTC drop. however, a prescription is needed. it is made by leiters pharmacy in san jose (special formula). Systane drops irritates the crap out of my eye

Once my doctor removes my permanant Smart plugs, I will have to see how my eyes feel to determine if I'll be using another plug. it is definitely helping.

When you first began using Restatis, you had no buring at all? I've spoken to many people, and all said there were some burning upon initial use.

[tealeaf]

Hi Chella,
Does gum cellulose help you?
I cannot use many eye drops and systane ultra is the one that can help (sometimes refresh plus helps). I have tried many OTC eye drops like cellusivc, bion tears, thera tears, tears naturale, blink, all make my eyes grittier.

When started restasis initially, I had slight stinging at night whereas morning was fine for me (I used the drops twice daily). The stinging lasted about half to 1 hour and for about 1 week, if I remembered correctly. I read in the forum that applying eye drop 5 mins prior to instilling restasis will help reduce stinging.

[chella21279]

Hi Chella,
Does gum cellulose help you?
I cannot use many eye drops and systane ultra is the one that can help (sometimes refresh plus helps). I have tried many OTC eye drops like cellusivc, bion tears, thera tears, tears naturale, blink, all make my eyes grittier.

When started restasis initially, I had slight stinging at night whereas morning was fine for me (I used the drops twice daily). The stinging lasted about half to 1 hour and for about 1 week, if I remembered correctly. I read in the forum that applying eye drop 5 mins prior to instilling restasis will help reduce stinging.

Great, thanks. At this point, I'm desperate enough to try anything to get me out of this misery.

Yes, gum cellulose works for me. It's also non-preservative and doesn't leave a thick residue. if you contact that pharmacy, the pharmacist can give you all the information you need (since the product is made in their lab).

I've tried many OTC drops as well and almost all of them did not help (probably made things worse) so I totally understand where you're coming from.

Are you still using the permanent plugs? How do they feel on your eyes now? I hope better. Your eyes should start feeling better and a bit more comfortable with them by now I would think.