I pushed my plugs in too far!

[suemom]

These are the third set of permanent plugs for me - each time, they work their way out, and the last time, I could see the plug getting progessively higher and it finally just dropped into my eye. I retreived it (so tiny) and stuck it onto a piece of scotch tape to show the opthalmologist when I returned for a new plug again, (just so she would know that I am not scratching them out). Also, each time I get a new set, the size of my puncta increases, (sort of like having a few children-LOL), so the size of the plug needs to be larger. I'm up to a 9 now. How large do they go to, I wonder? Anyway, last night I did a baaaad thing: o. I could see that the plugs were sticking up higher and higher each day, and I knew that it was just a matter of days before I would lose them again, and who knows when I would be able to get in to see the doctor again - she is usually booking months in advance....so...I took a sterilized flat rounded butter spreader, put it flat against the plug and pushed down a bit. Well, it just, shloop - disappeared down the hole! Definitely did not fall out or anything - just went right down the hole. So I thought in my infinite wisdom, that I would just press VERY gently when I do the other side, and it will just push it down just a little bit. So, once again, pressed ever so gently this time, but shluurp, down the hole it went also: eek. I have looked very carefully, and the puncta looks a bit bulgier than usual, but I can't see the top of the plugs at all, I can only see the rims of my puncta holes (looking like there are no plugs in there at all). My question is, has anyone else ever done such a thing, and secondly, do those in the know think that these should now stay just below the surface or will they just readily flow down into my throat? These were the kind (I forget the name) which had little a flattish top and looked like a little arrow. I'm surpirsed that the flat top went down the puncta so easily, as the idea is that it sits over top of the holes, and the tops are larger than the openings.
Anyone have any ideas? I have had one of my puncta flushed before when they weren't sure if the missing one was still in there, and I was not too fond of the procedure. My opthalmologist sent me to another Dr. for this procedure, and he was not very gentle - I could feel him poking down around close to my nose (sinus area I guess) , and it hurt! Do you think there is any harm in having the plug tops actually inside the puncta, or are they sure to migrate? Thanks for any help. Sue

[Lucy]

Sue, no one here can give you an answer that yes, the plugs will migrate down your throat, or no they won't. That being said, you need to follow up with a doctor. Stop messing with your eyes! (That being said, I have pulled one plug myself and pushed others further in.)

Many of the plugs do just flush through the throat and do no harm. However, if they're stuck in the canal, possible trouble lurks ahead. That's why I say to follow up with a doc.

Most of us with dry eye and plugs have had to mess with our plugs a bit, but it's not a good idea. They may have to flush you again if they can't tell whether the plugs are stuck in the canal. Good luck and let us know. lucy

[suemom]

Thanks Lucy!

I know I have to leave my plugs alone, but if I do, they will just keep falling out. I guess after getting this sorted out, the next step should be cauterization for me, since I am feeling much better with plugs - when they stay in, that is. Sue

[indrep]

Typically to push a plug into the canaliculus below the punctal ring you would have to use a pointed instrument and quite a bit of force. Not know how far up they were protruding I would guess when you pushed on them they actually popped out. At best, if you used something flat to push them down they should be just flush or below the punctal ring, a doctor should be able to see them. If that is where they are I would leave them alone. If you insist on having them removed have the doctor first try using a needle to "spear" the plug and work it out through the punctum.

Your doctor made the most common mistake when fitting plugs. He started with a .7(probably too big) when it dislodged they went bigger. If the punctal ring was not ruptured they should have gone smaller.

[Jen72]

Interesting, I have the same problem with losing plugs. In fact I had the Dr. push mine down as far as possible to avoid loss. The next step is cauterization, they are opposed to intracanicular plugs- they require surgery to remove apparently.

Was it painful when you pushed it down. Try looking for it with a flashlight, sometimes that is the only way I can see if they are still in. How do your eyes feel?

[kitty]

they are opposed to intracanicular plugs- they require surgery to remove apparently.

Not all doctors are opposed to intracanalicular plugs. Those are the only ones that my doctor uses. Intracanalicular plugs are generally removed through irrigation. Surgery is only needed if they get lost/dislodged and trapped in the lacrimal system, resulting in an infection or other problems. Not all plugs lost in the lacrimal system cause problems. Intracalicular plugs do carry greater risks than the surface type of plugs. Every patient should be thoroughly educated about the type of plug they are getting and the potential complications of that type of plug.

Please be careful when making such generalized statements.

[hkgcomet]

Oh! Do you push 4 plugs go into the duct? How to do with the upper? =.=

You are lucky that you don't hurts your eyeball...

I had a sad experience. Doctor remove 1 of my plug, but accidently half plug go inside and he just make it deeper and finally give up. It remains until now...It is now permanent, it is hard to wash down. One day my dry eye may recover but it is hard to take the plug out.

So sad...