Are Punctal Plugs right for me?

[ryan12345]

Hi everyone!

I have extremely dry eyes. They are honestly ruining my life. I'm 23 years old, and my eyes water in the worst situations. I think that this syndrome has caused anxiety problems for me, since now in very critical situations (like one-on-one meetings), I anticipate having dry eyes and the appearance of crying, and it therefore happens more, and makes me appear very uncomfortable and awkward as I try desperately to compensate for it. I've tried Restasis which did not work.

I'm considering punctal/punctum plugs. I'm wondering if you guys think this makes sense as a solution for me, given my unique situation:

I am incredibly light sensitive, and this paired with dry eyes is an absolute nightmare. When I'm in class, the florescent lighting affects my eyes so much to the point where my eyes water and I get tunnel vision, and can't focus on anything because my entire nervous system reverts to trying to fix the problem before anyone notices. It makes it so that I can't focus and I will literally spend 5 minutes completely dedicating all of my brain power to try and stop my eyes from watering. It creates a really bad cycle where I start to panic because I'm so worried that somebody will see me struggling to fix this. I often find that looking down as far as I can helps.

I am also a contact lens wearer and I'm wondering if that makes me a bad candidate for punctal plugs. And to be honest - I rub my eyes a lot - will they fall out?

This affects my life in such a major way. I am an extremely confident person on the inside, but on the outside, my confidence is completely shattered because I'm scared of my eyes watering in social settings. I talk to people less, go out less, see friends less, because I just hate how my eyes always water. I find I can't look people in the eyes for long because it just makes my eyes water. I am in desperate need of help - if I found a solution that fixed this, my life would be completely different.

Thanks so much for your help.

Ryan

[cathy8889]

I was just wondering what treatments you have already tried?

When I went to see an ophthalmologist in August I was determined to come out with punctual plugs, but during that appointment I was diagnosed with non-obvious meibomian gland disease, my glands were not clogged with toothpaste like oil they were producing very little oil and the oil that was being produced was of poor quality, because the three previous ophthalmologists did not try and express the glands or examine closely what was coming out they missed the mgd. The ophthalmologist said she would put me on 50mg of doxycycline for 6-9 months, she told me to continue with warm compresses, she didnt emphasise eyelid hygiene to me enough but this has also made a huge difference. I noticed a difference from the doxy in the first week, and then since August they have contunied to get better. The ophthalmologist told me that if the doxycycline did not work the next options were restasis and punctual plugs but she didnt want to put them in during appointment in august otherwise I wouldnt have known what was working. I am still experiening dryness, grittiness, lid swelling, so if this continues I will go back and ask for more help.

I really think you need to know the cause of your dry eye, three ophthalmologists and an optometrist missed my meibomian gland disease. The second ophthalmologist attributed 3 and 4 second tear break up time to aqueous tear deficiency despite the schirmer score not being that low. If your schirmer is high and tbut is low I think it suggests that you have mgd.

Cath

Hi everyone!

I have extremely dry eyes. They are honestly ruining my life. I'm 23 years old, and my eyes water in the worst situations. I think that this syndrome has caused anxiety problems for me, since now in very critical situations (like one-on-one meetings), I anticipate having dry eyes and the appearance of crying, and it therefore happens more, and makes me appear very uncomfortable and awkward as I try desperately to compensate for it. I've tried Restasis which did not work.

I'm considering punctal/punctum plugs. I'm wondering if you guys think this makes sense as a solution for me, given my unique situation:

I am incredibly light sensitive, and this paired with dry eyes is an absolute nightmare. When I'm in class, the florescent lighting affects my eyes so much to the point where my eyes water and I get tunnel vision, and can't focus on anything because my entire nervous system reverts to trying to fix the problem before anyone notices. It makes it so that I can't focus and I will literally spend 5 minutes completely dedicating all of my brain power to try and stop my eyes from watering. It creates a really bad cycle where I start to panic because I'm so worried that somebody will see me struggling to fix this. I often find that looking down as far as I can helps.

I am also a contact lens wearer and I'm wondering if that makes me a bad candidate for punctal plugs. And to be honest - I rub my eyes a lot - will they fall out?

This affects my life in such a major way. I am an extremely confident person on the inside, but on the outside, my confidence is completely shattered because I'm scared of my eyes watering in social settings. I talk to people less, go out less, see friends less, because I just hate how my eyes always water. I find I can't look people in the eyes for long because it just makes my eyes water. I am in desperate need of help - if I found a solution that fixed this, my life would be completely different.

Thanks so much for your help.

Ryan

[ryan12345]

Hi Cathy, thanks for your reply!

I was diagnosed with mild MGD and that's why I was put on restasis but it didn't help. Would you suggest lipiflow before or after trying plugs?

I was just wondering what treatments you have already tried?

When I went to see an ophthalmologist in August I was determined to come out with punctual plugs, but during that appointment I was diagnosed with non-obvious meibomian gland disease, my glands were not clogged with toothpaste like oil they were producing very little oil and the oil that was being produced was of poor quality, because the three previous ophthalmologists did not try and express the glands or examine closely what was coming out they missed the mgd. The ophthalmologist said she would put me on 50mg of doxycycline for 6-9 months, she told me to continue with warm compresses, she didnt emphasise eyelid hygiene to me enough but this has also made a huge difference. I noticed a difference from the doxy in the first week, and then since August they have contunied to get better. The ophthalmologist told me that if the doxycycline did not work the next options were restasis and punctual plugs but she didnt want to put them in during appointment in august otherwise I wouldnt have known what was working. I am still experiening dryness, grittiness, lid swelling, so if this continues I will go back and ask for more help.

I really think you need to know the cause of your dry eye, three ophthalmologists and an optometrist missed my meibomian gland disease. The second ophthalmologist attributed 3 and 4 second tear break up time to aqueous tear deficiency despite the schirmer score not being that low. If your schirmer is high and tbut is low I think it suggests that you have mgd.

Cath

[DryInDenver]

Ryan12345,

I am quad plugged and punctual plugs help me somewhat but our symptoms are quite different. I have an aqueous tear deficiency and they help keep what little I have in there. When I researched punctual plugs one of the common complaints I read about was excessive tearing. Since the plugs block the route the tears usually use to drain, they either have to evaporate or drip out of the eye. Since you already seem to have this problem, I'd expect plugs make it worse.

They may be worth a try because they are easily removed. I paid for mine out of pocket and they ended up being a few hundred bucks so cost would probably be the biggest drawback to trying them out.

I'm not sure what you've tried yet, but it might be worth looking into doxy, serum tears, warm compresses, lid scrubs, Fish oil/Omega3 pills, and some of the other treatments I see users with mgd mention on this site first.

[cathy8889]

Hi Ryan,

I agree with dry in denver, I think doxy, warm compresses, lid hygiene, omega 3s might be worth a try before plugs and lipiflow. I was thinking of lipiflow but because i dont have the mgd where the oil is like toothpaste secretions I dont know whether it would work.

Cath

Hi Cathy, thanks for your reply!

I was diagnosed with mild MGD and that's why I was put on restasis but it didn't help. Would you suggest lipiflow before or after trying plugs?

[ryan12345]

Hi! Thanks for your reply,

I see what you're saying - hmm. The only thing is, yes I have watery eyes, but I think it might be a bit different than you think - it's not really as if my eyes are always watering and that's tje problem, it's more like they are so incredibly dry that they are almost forced shut, and when they **** they create tears to compensate, and by now my eyes are so irritated that it's more the combination of irritation with watery eyes and now stress that I'm having, as opposed to just watery eyes. Am I explaining it well enough? I'm not sure if what I'm saying makes sense but it just seems like the watery-ness is a defence mechanism for my eyes under this incredible stress, almost like a last resort. Maybe that's why I get tunnel vision and that pain, because my eyes are working so hard to produce enough tears to remedy this stress? Not sure if that's even how eyes work but that's what it feels like! Because if I try and hold my eyes wide open for even 5 seconds, I get a burning pain, like I can feel that liquid evaporating. But then like I said I start to tear up to compensate.

I'm really desperate for a fix. It always seems like when I go to my eye doctor, they don't take this seriously. Some even have the nerve to say it's probably allergies. Warm compresses aren't enough - I just want a solution and I don't care how much it costs - I just wish I knew the right one!!

Thank you!

Ryan12345,

I am quad plugged and punctual plugs help me somewhat but our symptoms are quite different. I have an aqueous tear deficiency and they help keep what little I have in there. When I researched punctual plugs one of the common complaints I read about was excessive tearing. Since the plugs block the route the tears usually use to drain, they either have to evaporate or drip out of the eye. Since you already seem to have this problem, I'd expect plugs make it worse.

They may be worth a try because they are easily removed. I paid for mine out of pocket and they ended up being a few hundred bucks so cost would probably be the biggest drawback to trying them out.

I'm not sure what you've tried yet, but it might be worth looking into doxy, serum tears, warm compresses, lid scrubs, Fish oil/Omega3 pills, and some of the other treatments I see users with mgd mention on this site first.