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Yup. It happened to me too.
Talk about ironic.
For years I've been warning people not to get Medennium SmartPlugs (a thermoplastic intracanalicular plug to help retain tears on the eye surface).
Nine months ago my left tear duct became completely blocked quite suddenly. Literally within hours, I went from normal (my normal, that is) to tears pouring down my cheek. In the ensuing weeks I went through cycles of raging canaliculitis, keratitis, other itises. Those things calmed down but still flare occasionally. The blockage continued. During the day my eye alternates between dripping and oozing, sometimes both. I can't wear my scleral lens in that eye. At night, it goes bone-dry, erosion-inducing dry, the kind that not even goggles helps, only tape and goop. Then as soon as I'm up in the morning, back to streaming. Sometimes it's bright red, other times looks normal except that I appear to always be crying. I styled my hair to hang over that eye a bit till I couldn't stand it anymore and cut some bangs. The inflammation makes computer work very painful so I often tape the eye down during work and I've become an adept at whipping that tape off really fast when the UPS guy walks in so I don't freak him out.
Speaking of work, for 9 months I haven't been able to work full time because of the pain and vision. Disabled husband, me breadwinner, etc, so it's been stressful. I've been so fortunate to have my farm and offgrid tinyhouse project to keep me sane. When I hit a wall at work, I go home and work on my sheeps-wool insulation or garden or anything other than a computer screen.
I visited various doctors those first few months. The blockage didn't respond to any treatment.
Then I tried to 'background-noise' it the way I do eye stuff in general, hoping it would eventually go away, especially because I wasn't insured at the time and money's always tight.
Then one day a couple of months ago while puzzling once again over the suddenness of it, it dawned on me.
Way back in 2003, when I was living in London, my ophthalmologist put SmartPlugs in both my lowers. I was very dry. Other plugs were falling out. These ones were a new concept that expanded to fit after insertion. It seemed a reasonable thing to do. (Heh. So did LASIK, two years before.) What did I know. At the time I knew a lot less about dry eye products (what few of them there were back then) than about lasik vision complications which was my main problem. The bottom line was, I badly needed a way to get my eyes wet enough to tolerate gas perm lenses which were the only way I could see. I had no idea there were possible complications of these plugs, and even if I had known enough to research it, the product was brand new and there wasn't any literature about it.
One of those plugs came out. I don't remember when or how. Maybe a year or so later? Probably a sneeze. I just have a vague memory of gazing at a tiny piece of mangled something and thinking, Gee, I wonder if that's one of those plugs?
The other one, I *assumed*, eventually flushed through.
Right? Wouldn't it? I mean, plugs don't stay in there forever. I literally forgot all about it. Years and years passed.
Then a few months back it suddenly occurred to me. What if....? Naw. If I even mention it to the MD he'll probably think I'm nuts. It's been so long. Then I was emailing with an old RS complications buddy, who, sadly, after so many years of vision issues from RK, had to go through oculoplastic surgery for SmartPlug complications awhile back. His surgeon told him sometimes a plug may float around in the lacrimal sac for a long time doing no harm then migrate and get lodged somewhere where it starts causing problems.
Bingo. That's me. After a 3 month wait (trying to pick up any cancellation I could but no luck) I saw the only oculoplastic surgeon on my insurance yesterday, and he concurred that that's almost certainly what's going on.
So here I am, and don't know quite where I'm going with this. Doc does not want to cut me open to try to get it out because he doesn't know where it is. (One of my research points - there's got to be a way to figure out where it is, I want to know what that is and figure out how to talk my insurance into it.) Doesn't want to get as drastic as a DCR if it can be avoided. Doesn't want to do a stent, on what seems to me a rational basis (eg all my problems are from a foreign body lodged in there... why put another foreign body anywhere in there?). So, we're culturing my crud and waiting for my next canaliculitis flare-up to possibly help localize the thing, then talk again about what to do next.
Meanwhile back at the ranch... I'm seeing the days get shorter and wondering how on earth I'm going to drive my daughter to evening activities this fall and winter, with my left eye always so inflamed that the incoming headlights on our county roads are quite blinding.
Sigh.
[/sob story]
MY ADVICE TO ANYONE CONSIDERING PLUGS:
1) Do not get durable intracanalicular plugs of any kind.
I have been vocal in the past about SmartPlugs just because in the literature they seemed to have considerably more frequent and worse complications, but the fact is the problem is in the whole concept of intracanalicular plugs (that's any plug pushed all the way in - that doesn't have a little umbrella top sitting where it can be grabbed). It's not that they always cause complications. It's that when they do, the complications can be so bad and it's SO HARD to do anything about it without quite drastic surgeries, and even those don't necessarily work, which is another of the big concerns pointed out by the oculoplastic surgeons in the studies I've read. Once those plugs are in there, you can't see them, you don't know where they are, you can't reach in and grab them, and the available methods for removing them can cause serious harm by driving the plugs somewhere other than out the door.
2) Do not get any kind of plugs without informed consent.
Placement of plugs is, in insurance and medical terms, a surgical procedure. I am horrified at the stories I hear of people having these things placed in their eyes without even being told much less having a detailed discussion about the pros and cons and opportunity to research on one's own. ALL PLUGS can cause complications, yes, even the external 'punctal' plugs - which, it's true, CAN fall in rather than out and cause harm, especially if not sized right. Dissolvable intracanaliculars will at least not be there forever, but they're still a foreign body in your canaliculus while they last, and can cause canaliculitis. Have a look at plug manufacturers' websites. They provide informed consent forms, just like laser surgery centers give you before laser surgery. The doctors have an ethical obligation to provide you with this form and answer your questions, and you have a right to be informed before you get plugs. Do not consent to getting any kind of plugs without this. You have reason to question the medical ethics of any doctor who does not take this seriously!
If you have any doubts about what I'm saying, all you have to do is chat with an oculoplastic surgeon. They're the ones that really know. They all deal with people like me regularly. Ask THEM what plugs they think are safest.
EDIT: One last note. I want to apologize to anyone I may have ever encouraged to get the removable type of plugs (true 'punctal' plugs) without duly cautioning them about possible complications. Rare complications are still complications.
Talk about ironic.
For years I've been warning people not to get Medennium SmartPlugs (a thermoplastic intracanalicular plug to help retain tears on the eye surface).
Nine months ago my left tear duct became completely blocked quite suddenly. Literally within hours, I went from normal (my normal, that is) to tears pouring down my cheek. In the ensuing weeks I went through cycles of raging canaliculitis, keratitis, other itises. Those things calmed down but still flare occasionally. The blockage continued. During the day my eye alternates between dripping and oozing, sometimes both. I can't wear my scleral lens in that eye. At night, it goes bone-dry, erosion-inducing dry, the kind that not even goggles helps, only tape and goop. Then as soon as I'm up in the morning, back to streaming. Sometimes it's bright red, other times looks normal except that I appear to always be crying. I styled my hair to hang over that eye a bit till I couldn't stand it anymore and cut some bangs. The inflammation makes computer work very painful so I often tape the eye down during work and I've become an adept at whipping that tape off really fast when the UPS guy walks in so I don't freak him out.
Speaking of work, for 9 months I haven't been able to work full time because of the pain and vision. Disabled husband, me breadwinner, etc, so it's been stressful. I've been so fortunate to have my farm and offgrid tinyhouse project to keep me sane. When I hit a wall at work, I go home and work on my sheeps-wool insulation or garden or anything other than a computer screen.
I visited various doctors those first few months. The blockage didn't respond to any treatment.
Then I tried to 'background-noise' it the way I do eye stuff in general, hoping it would eventually go away, especially because I wasn't insured at the time and money's always tight.
Then one day a couple of months ago while puzzling once again over the suddenness of it, it dawned on me.
Way back in 2003, when I was living in London, my ophthalmologist put SmartPlugs in both my lowers. I was very dry. Other plugs were falling out. These ones were a new concept that expanded to fit after insertion. It seemed a reasonable thing to do. (Heh. So did LASIK, two years before.) What did I know. At the time I knew a lot less about dry eye products (what few of them there were back then) than about lasik vision complications which was my main problem. The bottom line was, I badly needed a way to get my eyes wet enough to tolerate gas perm lenses which were the only way I could see. I had no idea there were possible complications of these plugs, and even if I had known enough to research it, the product was brand new and there wasn't any literature about it.
One of those plugs came out. I don't remember when or how. Maybe a year or so later? Probably a sneeze. I just have a vague memory of gazing at a tiny piece of mangled something and thinking, Gee, I wonder if that's one of those plugs?
The other one, I *assumed*, eventually flushed through.
Right? Wouldn't it? I mean, plugs don't stay in there forever. I literally forgot all about it. Years and years passed.
Then a few months back it suddenly occurred to me. What if....? Naw. If I even mention it to the MD he'll probably think I'm nuts. It's been so long. Then I was emailing with an old RS complications buddy, who, sadly, after so many years of vision issues from RK, had to go through oculoplastic surgery for SmartPlug complications awhile back. His surgeon told him sometimes a plug may float around in the lacrimal sac for a long time doing no harm then migrate and get lodged somewhere where it starts causing problems.
Bingo. That's me. After a 3 month wait (trying to pick up any cancellation I could but no luck) I saw the only oculoplastic surgeon on my insurance yesterday, and he concurred that that's almost certainly what's going on.
So here I am, and don't know quite where I'm going with this. Doc does not want to cut me open to try to get it out because he doesn't know where it is. (One of my research points - there's got to be a way to figure out where it is, I want to know what that is and figure out how to talk my insurance into it.) Doesn't want to get as drastic as a DCR if it can be avoided. Doesn't want to do a stent, on what seems to me a rational basis (eg all my problems are from a foreign body lodged in there... why put another foreign body anywhere in there?). So, we're culturing my crud and waiting for my next canaliculitis flare-up to possibly help localize the thing, then talk again about what to do next.
Meanwhile back at the ranch... I'm seeing the days get shorter and wondering how on earth I'm going to drive my daughter to evening activities this fall and winter, with my left eye always so inflamed that the incoming headlights on our county roads are quite blinding.
Sigh.
[/sob story]
MY ADVICE TO ANYONE CONSIDERING PLUGS:
1) Do not get durable intracanalicular plugs of any kind.
I have been vocal in the past about SmartPlugs just because in the literature they seemed to have considerably more frequent and worse complications, but the fact is the problem is in the whole concept of intracanalicular plugs (that's any plug pushed all the way in - that doesn't have a little umbrella top sitting where it can be grabbed). It's not that they always cause complications. It's that when they do, the complications can be so bad and it's SO HARD to do anything about it without quite drastic surgeries, and even those don't necessarily work, which is another of the big concerns pointed out by the oculoplastic surgeons in the studies I've read. Once those plugs are in there, you can't see them, you don't know where they are, you can't reach in and grab them, and the available methods for removing them can cause serious harm by driving the plugs somewhere other than out the door.
2) Do not get any kind of plugs without informed consent.
Placement of plugs is, in insurance and medical terms, a surgical procedure. I am horrified at the stories I hear of people having these things placed in their eyes without even being told much less having a detailed discussion about the pros and cons and opportunity to research on one's own. ALL PLUGS can cause complications, yes, even the external 'punctal' plugs - which, it's true, CAN fall in rather than out and cause harm, especially if not sized right. Dissolvable intracanaliculars will at least not be there forever, but they're still a foreign body in your canaliculus while they last, and can cause canaliculitis. Have a look at plug manufacturers' websites. They provide informed consent forms, just like laser surgery centers give you before laser surgery. The doctors have an ethical obligation to provide you with this form and answer your questions, and you have a right to be informed before you get plugs. Do not consent to getting any kind of plugs without this. You have reason to question the medical ethics of any doctor who does not take this seriously!
If you have any doubts about what I'm saying, all you have to do is chat with an oculoplastic surgeon. They're the ones that really know. They all deal with people like me regularly. Ask THEM what plugs they think are safest.
EDIT: One last note. I want to apologize to anyone I may have ever encouraged to get the removable type of plugs (true 'punctal' plugs) without duly cautioning them about possible complications. Rare complications are still complications.
You know, I think it's really to your dr's credit that he is paying enough attention to the literature to stop fitting Herricks! Too many of them either never read anything outside their primary interest, or drink too much manufacturer koolaid. I remember a few years back when I went down to LA to one of the OC dry eye support groups, there was a speaker who was a very prominent local corneal specialist. This guy talked about how they can just put more smartplugs in if they aren't working or you aren't sure they're still there. He'd put three or four pairs in some people (shudder). He did NOT get invited back.
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