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Hello, I'm new here. I've had a severe dry eye condition only in my right eye for about 2 1/2 years. My lower duct is cauterized. I've had a plug in my upper duct for 1 1/2 years. I am using Restasis too. The eye was reasonably comfortable until the plug fell out 6 mths ago. Got another plug, bigger size, not quite as comfortable. I think it was sticking out and irritating the eye. Then about a month ago, that plug fell out. Got another new plug and eye felt wonderful, lots of overflow tears, for a week. I do feel tears when I have a plug. Then that one fell out. So about 10 days ago, my doctor decided to use an intracanalicular plug. I don't know the brand, but he said it was suppose to conform to fit and it can't fall out. Well, I never felt any effects from it...no tears building up, eye very dry and aches constantly. I'm using lubricating drops about every 15 min. It doesn't feel like I have a plug at all. It made no difference. Eye feels just like it did before he put it in. I know he inserted something in my tear duct. So what could have happened? Can this plug flush on through by itself? Could it have been defective and didn't conform? One other thing, I also use glaucoma drops, Azopt. When I put azopt in, I get a hint of a taste after a few minutes. I tested it in the right eye only to see and drainage is certainly getting through.
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Patty,
It would help to know what type he inserted. -
I'm sorry, I just don't know. He's very basic in his explanations to me. Didn't identify it by name. Only that it can't fall out, has to be flushed out, and that it will conform to fit. The eye felt a little more bearable today. But I always have good days and bad days. Really bad all weekend.Comment
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Can you give the office a call and ask them what brand of plug they used? At that time, I would also share with them your concerns. My doc told me what brand he would use and gave me a brochure from the company at the appointment before the appointment when the plugs were inserted, so I had time to do some research. The consent form was very explicit, and was given to me at that pre-procedure appointment as well. I wish more docs did this, and more patients demanded it.Every day with DES is like a box of chocolates...You never know what you're going to get.
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If it is a Smart Plug there are two concerns. First did all of the plug get inserted. This plug constricts in length and grows in diameter. Second, at maximum size it only gets to 8mm. Tears could be going around the plug.
If it the OASIS Form Fit the doc needs to make sure the Hydrogel plug is visible in inserter before inserting to make sure a plug is present in inserter. Sometimes when picking inserter up the plug is accidentally discharged. It doesn't happen often but I have seen it.Comment
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Thanks all for your comments. I did call the office and I'm scheduled to see Dr in the morning.Comment
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I have such large tear ducts that the ones that fit down inside won't completely occlude. They helped some. When I got the ones with the mushroom top I had instant and lasting relief with them. If I were you I would consider getting them all cauterized.Comment
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I should add, that yes, they flushed through within minutes (the first ones) because they were too big. Has your doctor checked to see if he can see it with that special light they use?Comment
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Just thought I would post an update. I went back to Dr, told him I had no effects from the intracanicular plug. As if no plug was there at all. He swore the plug can't come out. He put a temporary plug in to test it. Well, I didn't have immediate relief, but after about 4 days the eye began to improve. It got almost normal. Used lubricating drops only about 4-5 times a day instead of every 15 min. Then on Fri I woke up with all the eye pain back and it's been hurting and dry every day since. Obviously the temp plug had dissoved. I'm due back to see Dr in the morning. Can't wait to tell him the temp worked. Oh, I also found out the intracanicular plug type is the Oasis form fit. I really think that plug didn't get in there to start with. Dr had commented when I was there last that irrigating would be very uncomfortable. I guess even if I insist the plug is not there, he will irrigate to be sure. Is it very painful to do that? Guess I will find out. I already have plenty of pain anyway.Comment
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Irrigating is not painful, and not really what I would call uncomfortable, just shocking the first time you experience it. It will be about the strangest feeling you have ever experienced, I can tell you that. It is hard to describe, like a cold jolt going from your eye to the back of your throat. Your doc should numb the punctum first with a numbing solution. He should also give you a tissue, just in case the solution runs out your nose instead of down the back of your throat. It is somewhat like getting water up your nose, but not as uncomfortable as that.Originally posted by PattyH View PostEvery day with DES is like a box of chocolates...You never know what you're going to get.Comment
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I saw my Dr last week re this continuing saga of the phantom plug. He's not convinced that there is no plug in there. He said most of my pain is due to inflamation in the eye and gave me drops to get the inflamation down. Doesn't dry eye cause inflamation or is it the other way around? I am to see him again on Thurs. He felt the fact that the temp plug didn't work immediately but took a few days indicated the pain was more from the inflamation and that when the pain eased was when the inflamation had cycled down. I don't know if I buy that. The pain came back about the same time the temp dissolved. He said he will cauterize it if I want after the inflamation is down but will not irrigate it because he says it's too difficult to do. Is it safe to cauterize on top of a plug? (If there's really one in there) Anyway the drops have helped. Not as agonizing now. But I still have dryness with that scratchy, aching and I still get a hint of taste of the drops, so something is draining through. I'm really concerned about cauterizing the upper punctum since the lower is already cauterized. I still have hopes that some day this condition will improve.Comment
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I am not a doctor but in no way would I consider cautery if there was any chance a plug was still in there. If it were me, I would get another opinion. Any doc who claims to be comfortable putting the plugs in should be just as comfortable irrigating them out. Irrigating the plug out is no more difficult than putting it in. This is my own experience watching my doc perform both procedures on me. He had a heck of a time getting the upper plugs in, and no problem at all with the irrigation. Everyone is different. A second, even third opinion would not be a bad idea if you are considering cautery, or, if you just want reassurance that your current doc is on the right track.Every day with DES is like a box of chocolates...You never know what you're going to get.Comment
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I would second that
I had the smart plugs inserted. One flushed thru immediately or wasn't all inserted. I know he had a terrible time getting them picked up without breaking them. He commented that he needed to skip the second cup of coffee next time he was scheduled to do the plugs. One of the eyes improved for awhile so I guess the plug was there. Then I started getting a very red sore eye in that eye and has some yucky stuff draining from the tear duct. So I saw a specialist and he had to physically express the plug from the eye. It was causing an infection. He tried flushing it at first but it wasn't flushing thru. (I've had two sinus surgeries and things are messed up). Then after the eye had healed, I had both lower tear ducts cauterized. It helped tremendously for awhile. But I have Sjogrens and am producing almost 0 tears so nothing much helps.
Under no circumstances would I recommend sealing up a duct without getting rid of the plug or making sure the plug was gone.
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