I think my plugs are too small...

[Paula D]

Hi everyone

When I was 5 months post Lasik I got 5mm permanent silicone lowers which did not improve my situation much at all. There was a minimal increase in the volume of my tears but hardly anything. Then 2 months later I also had 5mm permanent silicone uppers which made a huge difference. The result was dramatic compared to just having the lowers plugged.

So, here is the thing, I think 5mm plugs in my lowers are too small. Visually they do not look like they fully occluded; I can see a tiny gap around them. Compared to my uppers which are totally wedged in and there is no space around them. Also my lowers are easily moved (although they have never fallen out) whereas I couldn’t move my uppers if I tried.

I mentioned this to my eye doc and he dismissed my theory saying that if they hadn’t fallen out then they must be the right size. I don’t believe him. Therefore he is unwilling to take these out and fit me with 6mm lowers. Part of me wants to pull the lowers out myself so then he is forced to put new ones in and I can ask for 6mm

Has this happened to anyone else? Does anyone have a view on it? I would be very grateful for some opinions.

Thanks

[indrep]

Paula,
They should be flush to the punctal ring. There should not be a gap between the plug and punctal ring. This more a comfort and retention issue than an occlusion one. The "anchor" of the plug is stopping the tears from moving through canaliculus.