Informed consent for plugs

[Rebecca Petris]

Insertion of plugs is, technically, a surgical procedure.

I would like to know how many of you were given an informed consent form before having plugs inserted. Some makers of punctal plugs provide informed consent forms for doctors to use, but whether they use them is another question. I have heard several reports of people having plugs inserted without even being told beforehand, and of course many reports from people having plugs put in with no discussion whatsoever of what the risks or alternatives might be.

If you currently have, or have had in the past, punctal or intracanalicular plugs, please respond to this poll (unless you don't remember whether you had informed consent). If you have had more than one plug experience, just respond about your most recent one.

How do I know what type of plug I have?

PUNCTAL PLUGS sit right at the entrance to the tear drains. You can usually see the white cap in the corners of your eyes if you look carefully.

INTRACANALICULAR plugs go all the way in and can't be seen. SmartPlugs are an example of a widely used intracanalicular plug.

[mgshutterbug]

Punctal plug inserted, never asked for permission

Hi Rebecca,
My permanent punctal plug was inserted w/o so much as a perfunctory statement from my corneal specialist, such as "your dry eye problem is so severe, I think a punctal plug might be indicated." It was my first visit w/any eye specialist after awakening several mornings and barely being able to see, and having severe eye pain. It was my introduction to him, RCEs, and virtually no information being given to me re: anything related to DES, the specific dx I had (which I asked about only after I had discovered this website, and read re: the plethora of conditions contributing to DES). When I asked about them specifically, then he confirmed that I had them. He did not elaborate on any of them, and I have, as I think I told you, EBMD, RCEs, deficient aqueous film partially caused by neural damage from recent neurosurgery to trigeminal nerve, MGD, partially anesthetized eyeball, on and on. Re: the plug, he simply muttered something to the resident (teaching hospital), and inserted the plug. No explanation of what it was called, what it was for, how it was to be inserted, and certainly not whether I would give my permission to insert one.

I would switch to another teaching hospital in the area with a prominent eye institute, but do not currently have the money to do so. But it would be nice to be informed of what my diagnoses were, explanation of same, prognoses, and possible treatments. I am going to be very insistent I get these at my next visit with him.

Maria

[vmpummer]

The punctal plugs were explained and discussed with me but no consent form offered.

[PotatoCakes]

Punctal plugs
No consent form with either doctor that's inserted them (2 diff practices too)
But we discussed (a little) and I definitely knew they were being inserted. I asked the 2nd dr to put them in. Interestingly, my lower ducts have apparently scarred over so we didn't do those but he put them in my upper ducts, which I didn't even know existed until he mentioned them. Insertion into upper ducts is definitely more unpleasant than lowers.

[ryanross]

Informed consent

I recently had one plug inserted by my ophthalmologist (just one because he wanted to see if there was a difference between eyes), and was told of all the risks, how the procedure was done, and was given a consent form to sign