Plugs Question

[Guest]

I have been persevering with being quadraplugged with Oasis permanent plugs for nearly a week now.

I have two issues with the plugs:
1. Tear Overflow - most of the time now I seem to have far to many tears and am mopping up a fair bit.

2. I seem to keep getting poked by the plugs if I look to the extreme in either direction which is not a nice experience (and particularly nasty in traffic).

I return to the DR on Tuesday and am thinking of asking to have the top ones out all together - just not sure if a week is long enough to get used to them but I can't put up with this either.

I had temporary plugs before these (Oasis 90 day) and was never convinced that they did anything (given my experience with them they most likely fell out), but when the permanent ones went in the bottom, I felt some relief from them alone, the DR was a little hesitant to put in top ones as he tought that my tear production was quite good on the Wednesday visit but thought it would be a reasonable to trial them.

The good side is that I haven't put any drops in for days as the drop just runs straight out, the downside is that I can't cope with the blurry vision from too many tears either.

Lucy you seem experienced with overflowing (from one of my other posts), what are your thoughts.

Ian.

[Guest]

Lucy/Diana

Both of you have mentioned overflowing in other posts.

Lucy you mentioned that this may pass quickly and by the sound of it you were happier with the overflow (while it lasted) than without.

Diana I read that you are cauterised - did you get the overflow problem after this or with permanent plugs as well and do you still get it now.

I am just feeling lost again, I woke this morning with minor abrasions in both eyes (although I did put the Genteal Gel in and also wore my Tranquil eyes) and I had a good day yesterday - seems a bad night follows a good day at the moment.

I am thinking of asking for my top plugs to be removed and will use drops as/when needed. At the moment, I can't/don't use drops because as soon as I put it in, the drop is rolling down my cheek. I feel that I got some relief with permanent bottom plugs than I ever got with 4 temporary ones.

I would appreciate your comments as I am off to the DR for yet another appointment tomorrow.

Take care

Ian

[indrep]

Ian,
The collagen temporary plugs only last about 3-4 days. The extended duration (90 day) plugs can last from 80-100 days. I would probably give the plugs a couple weeks before deciding to take them out. Really you should give it at least four weeks. At four weeks the benefit from increased tear on the eye has usually decreased the osmolarity of the tears and this allows the healing process to begin.

If at the end of four weeks you just can't stand the excees tearing, if its still there, then have the most uncomfortable ones removed. You can always go back and have a Flow Controller plug inserted. This is similar to the silicone plugs but is really a tube in that it allows some tear to pass through.

[kitty]

I would agree with Indrep. When I got my two uppers plugged, it took at least 2 weeks to notice nominal improvement, and about 4 weeks to really notice a difference. I had already had my lowers plugged for several months without any significant improvement.

[Guest]

Indrep and Kitty

Thanks for taking the time to reply. Unfortunately, I received your replies after I had been to the DR.

When I walked into the clinic today, before I even got to the chair, the DR looked at me and said, we need to take the upper plugs out - too many tears.

So out they came, I must admit, that I am a lot more comfortable without them - not scratching my cornea and reflex tearing everytime I move my eyes in the wrong direction is an absolute blessing.

I have had all 3 variety of plugs now, collagen and 90 day Oasis extended duration and now the long term (permenant).

I have noticed a significant difference from being quadraplugged with the 90 day extended duration and just having the long term plugs in the bottom, I have found the 2 bottom silicone are better than the 4 extended duration.

I must admit that I never really had a lot of faith in the 90 day plugs as they have come out a few times (soon after insertion) and usually after I have commenced my 200 mile journey home from the clininc.

I felt instant relief when he removed the top plugs today, my vision cleared up as the tears drained away. I spent the rest of the afternoon on the computer and have just endured a 2 1/2 hour trip home and still feel relatively comfortable at 12:15 am.

I am certainly going to persevere with the bottom permanent plugs as I don't feel them at all.

Again thanks for your replies, I hope I haven't been too premature in getting them out, I guess I will see in the coming weeks whether it was a smart decision or not.

My next challenge is to get the vision in my right eye back to what it was before the erosion took the clarity away. If I recall the last abrasion I had took weeks to months to becomre really clear and crisp again - oh the joys!!!!!

I often wonder how boring my life must have been before I got dry eyes and I wonder now what I used to do all day before drops, gels, compressess, lid massage, research, doctors visits.

Cheers

Ian

[dianat]

Ian,

Sorry, I missed much of this thread when it mattered to you. I'm glad you felt some relief today and are happy with your decision to remove the uppers. Whenever I've made eye decisions that gave me immediate relief, I've felt they were good decisions in the long run also.

Regardin my experience...

I have tear overflow all the time now, but the overflow I have with cautery is different than what I had with upper and lower plugs. The plugs in my upper punctae was regularly rubbing on my sclera and causing excessive reflex tearing. At certain times of the day my poor eyes would burn and tear...streaming down my face. At the time I was new to dry eye and was so confused by what was really happening.

Later I learned that that rubbing was really causing problems, making upper plugs simply the wrong answer for me. Lower plugs alone didn't make much difference in my overall comfort.

Because I was just BONE dry, I did opt for cautery. I do have an overflow and blot my eyes repeatedly throughout the day...and I mean A LOT. I blot with a tissue several times an hour....more if I'm talking, laughing or doing things that might make my eyes well up. It's incredibly annoying, but it's better than my lids "dragging" over my eyeball like they did before cautery.

Best of luck at this juncture, Ian.

D

[Silverlady]

To Ian,

Just a short Congrats Ian. I hope the rest of your dry eye journey is as easy as taking the two plugs out and getting relief. I am sure glad this worked out for you.

Billye

[Lucy]

My experience was probably a lot like Diana's. I had overflow more while I was still able to work 2 years ago and prior. It was the same situation she is describing. I had one of my plugs pulled because I was having a lot of pain about 9 months ago. Well, after doc pulled the plug, he looked beneath the eyelid as I asked him. I had a speck of sand in my eye that was causing all the extra irritation. Since then, this eye has been worse.

This proved to be an error that has caused me a lot of grief and more DRY EYE. He cannot get a plug into that puncta(e)? now. He tried ordering SmartPlugs which he had never used before and it would not go in. I was then cauterized and I'm not sure it "took." I have an appointment next week with him and will discuss re-cauterizing this one eye again. Just recently, cauterization has made more sense to me since I won't be cured any time soon. The present lack of overflow is because of: doc pulling one plug, probably just the natural progression of my dry eyes. I will say that my eyes were feeling a lot better with the overflow.

Just gotta get the right combo, Ian.

[Guest]

Thanks for your comments everyone.

I am hoping I made the right decision. The really nice thing is that I am not getting poked in the eye anymore and I can move them normally.

I agree that my top plugs were rubbing causing reflex tearing. Fortunately, I am not bone dry anymore so I am producing tears (questionable quality - yes) but at least I am not dropping or mopping every 10 minutes now.

Hopefully I have the balance right with the bottom plugs - only time will tell.

Thanks again

Ian