Am I the only one who hates these plugs?

[Jeanz]

Punctal plugs were put in last week, but already one has fallen out and the other one I want taken out right away! They're itchy and scratchy. Everyone seems to love these plugs except for me! Anyone else feel like I do?

[indrep]

I can't tell you how important it is to properly fitted for plugs. Even measuring one side does not insure you are properly fitted, 30% of patients have different size puncta.

Also, even with proper sizing the anatomy of your lids and globe can cause the plugs to be uncomfortable. In some instances regular visits to have long term dissolvable intracanalicual plugs or permanent intracanalicular plugs might be options.

[kitty]

I'm no expert, but I can tell you that even with intracanalicular plugs, I had an adjustment period. I was aware of the plugs for the first couple of weeks. They poked me and my eyes itched like crazy. Just when I was about to call the doc to have them flushed away, the irritation stopped. I suggest a call to your doctor if things don't seem to be getting any better.

[bassfan]

Ive had various plugs put in about 4 times. They either fell out in stayed in but drove me nuts in the case of the enormous .9mm odysseys i had last time in my lowers. I have had .6mm oasis surface plugs in my lowers for three days now. At first i could really tell they were in there. Now i dont notice it near as much. I can tell if i turn my eyes so that my pupil is rubbing over the plug though, that doesnt feel very good. The right plug is worse than the other, i dont think its pushed in far enough.

Both Kitty and Indrep said very important things. I would say that its more of a trial and error thing instead of fitting however, at least in my case. If insurance is paying for it, I guess thats not a problem. I've anywhere from .4mm to .9mm in me.

Id say give it a week or so and if its still bothering then just try something else. Theres a lot of different brands with a lot of different designs. Somewhere on this website is some descriptions and pictures. I've had my doc order me the ones i wanted to try but he pushes these dumb oasis ones on me as he thinks they are the best. I think he just gets them cheaper or something. Im partial to eagle plugs myself, seems they have the widest selection.

Daren

[Rebecca Petris]

Somewhere on this website is some descriptions and pictures.

Punctal plugs

[indrep]

Most companies have size gauges that are available to the docs. Most will give the doctor a set if he promises to use it. That's how important the companies think the right size is for retention and patient comfort.

[aLensUsr]

I did not like plugs either.

Not only was I aware of the (collagen) plugs, but they made my eyes feel worse. I am now seeing a doctor who specializes in dry eye and and have discovered that I have blepharitis/MGD/ocular rosacia (doctor tells the these are all really the same condition). As indicated elsewhere on this forum, if you get plugs without treating the underlying inflammation, you end up soaking your eyes in "toxic tears".

I am now getting some relief with the blepharitis treatment, which includes
1) initial tobradex
2) minocycline
3) eyelid compresses (10 min), massage, & lid scrub
4) restasis

[Dot]

what's lid scrubbing?

Hi

So what is the lid scrubbing about? I've also seen the term "lid hygiene" used too. I am totally and utterly ignorant on what this is... Thanks for responses ahead of time

I have the collagen plugs that are supposed to last 3 months and I know they aren't wide enough because I am getting some tear drainage into my nose a little. Now I am starting to believe I will need to get them cauterized. Would he do that with the collagen ones present,anyone know?
I am still doing Restasis, liquigel, tranquileyes and refresh tears. Now that it's getting warmer though and dryer my eyes sure are feeling it.

Rebecca, I have sent notes to several threads but could never find them to see if someone responded. Is there a way to get to those quickly? (I'm dry eye zone disabled I think!)

Thanks!

[Rebecca Petris]

So what is the lid scrubbing about? I've also seen the term "lid hygiene" used too. I am totally and utterly ignorant on what this is... Thanks for responses ahead of time

A common cause of dry eye symptoms is meibomian gland dysfunction. Meibomian glands are the oil glands located in the upper and lower eyelids with orifices at the lid margins. From those openings they secrete oil onto the tears which retards tear evaporation. Inadequate oil secretion = fast evaporation = dry eye symptoms & pain.

Often the cause of MGD is blepharitis, which can be treated with lid care. There are typically two components to this:
1) Clearing existing blockage by loosening and expressing the glands. This is why you read often here about warm compresses, and lid massage.
2) Keeping lids as clean as possible (hence the references to lid hygiene, lid scrubs etc.) I usually do this with a Q-tip and saline. Others may use commercial lidscrub products, or special products with tea tree oil to treat demodex mites.

Dr. Latkany's book has a really nice explanation with sketches.

Rebecca, I have sent notes to several threads but could never find them to see if someone responded. Is there a way to get to those quickly?

Yes!

An easy way to make sure that you know if there is a response is to "subscribe" to a thread in which you have posted. After you post in a thread, while you still have the thread open on your screen, look up towards the top right. There are two blue bars. In the lower one, the left-most option should read "Thread Tools". Click on that. The third option from the top in the little menu that comes up will say "Subscribe to this thread". Click on that. It'll take you to a little screen - just click on the button in that screen that says "Add subscription". You will then receive an email anytime someone posts in that thread. If you get tired of it just follow the same procedure to UNsubscribe to the thread.

Another way to see activity without getting the emails is to use a little tool that finds all the recent threads you have posted in, then you can look at the threads one by one. Go to the Members List (blue bar at top) and find yourself. Click on your username. Then at the left you will see options like "Find all posts by XXX" or "Find all threads started by XXX".

Hope this helps

[IanJ]

Hi,

I've had the same problem with plugs......it took at least a couple of weeks to be relatively free of the itchyness and scratching.

My latest ones sat high, or popped up from time to time.....I pushed them down using the wrong end of a toothbrush. This operation got less and less as they began to sit properly.

The way it was explained to me was that the muscle around the plug needs time to settle down, especially if the hole was dialated by the doc before he put the new plugs in........as was the case with me.

Ian.

[Bennys]

I am actually going to have my upper eyelid cauterized tomorrow. I had 3 different plugs in my left eye. The first one came out almost right away. The second one stayed in for quite a while, third about 6 months. My doctor told me the next time it came out, he was going to cauterize my tear duct. Maybe it's a good thing as that plug bothered me for some reason. I was always aware of it - but there is no way I can go without the upper eyelid being closed. This is my really dry eye!!!! Anyone out there work on a computer all day? That's my big problem. By the end of the day, my eyes are so sore and tired.

[Helene]

re being cauterised.

I am very interested in anyone that has had their eyelids cauterized. At present I am too struggling with plugs and this seems a lot less intrusive and you don't have to worry about the plugs coming out and scratching your eyes. I have had two plugs inserted. One top and one bottom. The top one I can still feel is there but the bottom one fell out and I had it replaced. It was not the same though. My eye felt extremely dry in the morning and had to keep putting in liquid tears. By the afternoon it was a little better and at night it started to get sore again. Also it is very itchy and hence that is why perhaps you unintentionally rub the bottom one out.

Hoping to hear from you how you went re cauterization. May be facing that shortly and would like to know how effective it is.

Thanks again.

HELENE

[Niteyorkie]

Cautery

My eye doc went straight to cautery with me. And compared to what most people say about the plugs, it was really easy. It stung some, and my eye lid was a little sore, but it wasn't bad. I did it on my lunch break and went straight back to work. I only had my botton ducts done. He put some numbing drops in my eye and then touched the cautery to lid, then I was done. I have asked him if it was reversible and he said yes, but I would have to go to eyelid surgeon.
I had a plug in my top eyelid and could always feel it. It drove me crazy and I finally got it to fall out.
With the cautery, you do it and it's done and you don't have to worry about anything scratching your eye or getting infected.
One of the ducts did re-open and he did a touch up and I have had no problems for 2 years now.

[Helene]

Cautery

Hi,

I went today to the Prof. and he said he was going to cautorise all 4 ducts of my eyes. Got a bit of a shock as I thought he would only do the bottom ones first. Have had plugs but no success. Still was very dry. Has anyone had all four done?

Would love a reply.

Thanks for that.

HELENE

[dianat]

I've had and still have all four punctum occluded. (Is punctum spelled right?? I need some coffee... )

Anyway, my eyes are generally very weepy and need to be blotted often. It's not an ideal situation, but it's so much better than the excessive dryness I had. Before cautery, my eyelids felt like they skipped across my eye when I blinked.

I do recommend you continue to do compresses and your usual regimen once you are cauterized. Your eyes will likely still need great care for optimal comfort.

Best of luck to you.

Diana