Update: 3 weeks with 4 plugs

[LasikLady]

My observations thus far:

Week 1: Overtearing that stung my upper eye lids like crazy. Tried using vaseline on eye lids but that made eyes burn. Hated my upper plugs, wanted them out. Upper punctum hurt from insertion adding to reflex tears. Reflex tears are NASTY and burn. Punctum itch at times severely.

Week 2: Went back to eye doctor, wanted plugs out, he said not yet and said stop the Restasis. This made my eyes a lot better. I never had an issue with the restasis burning my eyes but I think sitting on my eye balls with no way to drain maybe was subjecting them to the medication for too long of a period of time. I now do hot compresses religiously. On good eye days I'm loving the plugs because for the first time since lasik I can watch t.v. at night and have conversations with people in the evening and hold eye contact with a decent degree of comfort. At this point loving my doctor for not letting me take them out.

Week 3: Here's where I am now and hopefully will stay or get even better. On my good eye days my eyes feel "almost" normal. I have to carry a tissue and dab at the inner corners of my eyes very frequently because having excess moisture there bugs me. That is a pain but the tears on good days do not sting or itch my eyes. People do look at me funny for dabbing my eyes frequently but nothing is perfect. And I have more comfort in the evenings than I've ever had since jacking up my eyes. On bad days the extra tears which I assume are reflex tears migrate to my upper lids and then I have the burning and itching again. Mind you, never have I had an allergy to anything in my life and this started with the upper plugs so I know it's from the excess moisture when my eyes are irritated. One thing I discovered which might me helpful to others: when my eye lids are itchy-burning I put some genteal gel there and it stops the burning and when it migrates into my eyes it's no problem because it's meant for the eyes!! I tried all sorts of eye creams and gels and they burned my eyes. I thought this discovery was genius

So basically my good eye days are way better than before upper plugs, but my bad eye days are somewhat worse than before upper plugs. But the hot compresses can really offer me tons of relief afterwards and help turn a bad day better. All in all I'm happy for the plugs right now and glad they didn't come out.

I'm sleeping in genteal gel, doing hot compresses 2x daily, and using PF systane if I need it during the day and in the morning when I wake up.

A note on Dr. Holly drops: For me, I don't like them. Sorry to say, I know many of you love them. I have only tried them twice (dwelle, dakrina) and both times were either last thing at night or first thing in the morning. They burned my eyes. And that is weird because no drop has ever burned me before. Maybe it's something to do with the upper plugs because I tried them for the first time after being totally plugged. My ocular surface has always looked great even though my eyes haven't felt that way so I know it's not because I have damage there. I don't know what's up with this and am very dissapointed. Systane has always felt great to me so I guess I will just stick with that. If I get gutsy I may try Dr. Holly's drops in the day when my eyes aren't as dry.

Sorry for the length of this post, just wanted to share my experiences for anyone considering 4 plugs. All in all I'm very glad I have them even though the dabbing of the inner eye is a pain. The extra comfort, especially in the evening, is worth it (so far).

[Rojzen]

excellent log; but challenge one assumption

Thank you, LasikLady, for the immensely helpful details about your progress on double-plugging. . .J

I just wanted to inquire a little into the assumption that because your ocular surface looks great (presumably on examination), it is actually in perfect shape, such that no eyedrop that is not caustic, in composition, should ever sting. . .

I have come to believe that slit lamp flourescein eye exams reveal only some of the more superficial details of the condition of the various layers of our corneas,and that even when we don't produce corneal staining, something subtle may still be going on that can greatly affect tear film stability. I say this because I was able to improve my own tear film stability, recently, after ten years of being hugely symptomatic (and having eye exams showing basically OK corneas), simply by focusing on treatment of the ocular surface with Dwelle and FreshKote. . .It is unpleasant when these drops sting, yes. . .and sometimes they continue to sting, for me, on instillation, even after over 7 months of steady use. . .but rather than condemn the drops as caustic, I conclude that my corneas are still not perfect, and that they experience subtle damage over a period of hours, that, I hope, is being reversed by regular treatment. . .

Anyway, if your eyes sting from the Dr. Holly drops, I wonder if you would consider the possibility that you have corneal stress that is not being picked up on regular exams. . .This might, in turn, provide a signal that you could benefit by treating that stress. . .The great news is that if the stress is so subtle that your slit lamp exams are always normal, it is probably easily treatable, if one uses the right therapy. . .

I have always like Systane, and admire the gel matrix approach it uses, but I find Dr. Holly's refutation of gels to be more convincing, in theory, and also in the context of my own subjective experiences, in which Systane never increased my TFBUT, whereas Dwelle and FreshKote, used for an extended period, did...

Anyway, what I'm trying to convey is that actual improvement in tear film, and not just symptomatic relief, can be a long haul, but if started, it beats the status quo any time, for me

[LasikLady]

Well, I am sure up for giving them another try. But I think I will try them at first during the day if I need drops. I know many here swear by them and I am up for anything that will actually improve my condition rather than just calm the symptoms.

[Andrea3]

relief for lid discomfort from over-tearing

I read through your post...when I am dealing with over-tearing, I find that rubbing a little olive oil around my eye lid helps my skin when it is irritated.