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Infection in lower punctum with Smart Plug
I have had Smart plugs in my lower punctum for about 2 years now with no complications. I recently had the upper punctums plugged with temporary collagen plugs to see if I would get even more relief. In my left eye, my eye doctor "accidentally" put in a long term (3 month) temporary plug instead of a 3 day plug. I had a a lot over tearing for about two weeks, and then it eventually stopped.
About a week later, I noticed some swelling and itching in the lower left punctum area. It is now infected, with no pain, but redness and pus.
My doctor knows that I have a Smart plug in that punctum but does not want to irrigate it out yet. Instead, he is choosing a more conservative approach of antibiotics, because he is certain that the infection is not due to the Smart Plug, but rather the two weeks of over tearing I had in that eye. He says the "stagnant" tears that rested in my eye for two weeks caused a bacterial infection.
Does anyone have any more information or advice? I have only been on antibiotics two days, and the itching has gone down dramatically. The redness and swelling haven't receded that much, but it certainly isn't getting worse either. And again, there is no pain at all, which my doctor says is a very good sign.
Should I push to see a specialist to get the plug irrigated (my doctor told me a specialist would have to do it because he doesn't do it in his office)? Or is antibiotics a "normal" approach to a punctal infection before irrigation is even attempted?
Any advice would be extremely helpful!!
I know this is why MANY people refuse to get intracanalicular plugs but I had an extremely hard time with surface plugs and these plugs were great when I got them!!
About a week later, I noticed some swelling and itching in the lower left punctum area. It is now infected, with no pain, but redness and pus.
My doctor knows that I have a Smart plug in that punctum but does not want to irrigate it out yet. Instead, he is choosing a more conservative approach of antibiotics, because he is certain that the infection is not due to the Smart Plug, but rather the two weeks of over tearing I had in that eye. He says the "stagnant" tears that rested in my eye for two weeks caused a bacterial infection.
Does anyone have any more information or advice? I have only been on antibiotics two days, and the itching has gone down dramatically. The redness and swelling haven't receded that much, but it certainly isn't getting worse either. And again, there is no pain at all, which my doctor says is a very good sign.
Should I push to see a specialist to get the plug irrigated (my doctor told me a specialist would have to do it because he doesn't do it in his office)? Or is antibiotics a "normal" approach to a punctal infection before irrigation is even attempted?
Any advice would be extremely helpful!!
I know this is why MANY people refuse to get intracanalicular plugs but I had an extremely hard time with surface plugs and these plugs were great when I got them!!
It really does sound like you're on the right track. And you've been successful all this time with the lower plug up until this point. 
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