Top plugs only?

[mspirk]

Just curious to find out if anyone has had only the top plugs inserted as opposed to having the bottom ones in also.

I have been having overflow issues with all four, and a few months ago, decided to have one plug removed from my right eye to see if the tearing would be reduced (at least in that eye, which watered the most). The doctor chose to remove the upper plug, and almost instantly, that particular eye became VERY dry. After a few days, I decided I couldn't take having to go back to constantly putting drops in, so had the upper plug reinserted and resigned myself to just deal with the overflow.

With so many of you, just having the bottom plugs in doesn't do much at all, but with all four, the tears are streaming down your faces. That made me wonder whether just having the top plugs in would make a difference in the tear flow. Anyone??

[kitty]

Click the link to view info in another thread. Have you talked with your doctor about flow control plugs?

Lowers vs. uppers

There used to be a theory that 60% of tears were removed by the lowers and 40% by the uppers. This is no longer thought to be the case. The prevailing thought is 50/50 from the upper and lower puncta.

[mspirk]

Interesting thread. There are a lot of theories, but I still would like to hear from someone who has had the uppers only plugged. Kitty, could you or someone else explain how flow control plugs work?

[indrep]

Mspirk,
Uppers used to be the first stage of punctal occlussion but after some studies showed that it was a 50/50 to 60/40 drainage everyone started doing the lowers first. Mostly because they are easier to put it in. Also in the old days plugs were much larger than today. The theory was big stays in better. We now know that the correct small size stays in better.

The flow controller plug is similar to other silicone plugs but has a cylinder that runs completely through the plug. This allows some drainage of tear through the punctum. This is a good solution for those where one plug helps but two plugs are too much.

[mspirk]

Thank you, indrep, for answering both of my questions!