swollen inner coner of eye lid..need advice

[sazy123]

Hi

Since my eys went bad again - a week ago. My left bottom inside eye lid, inner corner (closet to the nose, above the punctum) looks redder, a bit more swollen, and sore, than the same place in the right eye. The difference is quite big.

Everytime my eyes have gone bad over the last year i notice the same thing in this corner, but when they return to feeling good it goes away, probaly due to better tears.

I had smart plugs put in 3 years ago, i thought by now they were long gone, but Dr Latkany said they were still there.

I think i can see one in the punctum of the redder, swollen eyelid. But i cant see anything in the punctum of the other eye which isnt swollen.

Does anyone think that this plug is irratating the punctum, and making it red and sore? And should i get it flushed out? Theres definately a large difference to the other eye.

has anyone had this happen where a plug has made there inner eyelid, corner sore?

What is it like to flush out a plug? is it easy? does it hurt?

Any comments would be appreciated. coz i dont want to try the sclerals again untill this is sorted.

Thanks

[kitty]

It could be the plug causing some irritation. Rather than having it flushed out, it might just need to be repositioned. I have had both procedures done for intracanalicular plugs. The doc will probably put some numbing drops in. To reposition, the doc uses a special tool that is inserted into the puncta and used to push the plug further in. To have the plug flushed, the doc attaches a tiny tube to a syringe filled with saline (no needle). He/she inserts the tube into the puncta then pushes on the plunger of the syringe, forcing the saline into the puncta. The pressure from the saline forces the plug to be flushed away. I felt a brief twinge of cold then a slight drip down the back of my throat. It was a strange feeling but it did not hurt.

If you go to this web page and use the drop down box, you can see a video of the irrigation process. Punctal plug irrigation

[rkralman]

Plugs are not always a good idea! Here's why!

I had Smart Plug put in lower right punctum....it migrated down and the doc said it was gone so he put another one in....that one went bye bye too, soooo.. he put another one in. Eye was red and itchy around and in punctum! Continued to swell and I kept telling him that it felt like the plug was irritating it. I also said it felt like other plugs were still in there. This doc denied this so I went to another doc who SQUEEZED out three plugs that had migrated down in my punctum!!! BUT, the damage was done. The previous plugs had irritated the punctum so badly that it formed scar tissue and closed off the punctum. I have had two DCR surgeries to try to correct this. The first surgery failed and the second one looks to be failing too as the lacrimal sac is getting scarred over again. I have to go through another surgery to get a permanent Jones tube placed in this eye and it will be there the rest of my life. Some people are very sensitive to the material in punctal plugs and can get a reaction such as redness, mucus, itching, and swelling. If you are experiencing this, it may not be the right choice for you. Try another brand or just stay away from them altogether! I wish I had!

[Judy]

Sazy, sorry you are having such tough times... I agree with Robin (rkralman) that plugs are not always a good thing...

Robin,

We definitely have some things in common. Check on the link below for my dry eye story.... Sorry you had the same issues with DCR's. What a pain. I have not gotten the Jones Tube yet and am putting it off as long as possible... God Bless!

http://www.dryeyezone.com/talk/showthread.php?t=1710

[skygoddess]

Hi,
I also had smart plugs put in a couple of years ago, and I have had nothing but problems since.
My corneal Dr.s kept blowing me off and saying it was just my blepharitis,
( I have the same symptoms as you )
The result was 6 months of untreated dacrocystitis. Till someone sent me to The lid Dr. , who said the plug was in my lacrimal sac and causing infections.
The irrigation only works if the plug is not in the lacrimal sac.
After reading about Judy and her experience, I backed out of surgery to have it removed. ( I took antibiotics, which cleared up my infection)
But the infection keeps comming back, and now I am having to consider the surgery again.
I feel stuck between a rock and a hard place.

[Judy]

Skygoddess,

I'm sorry you are having such a bad time with the infections. My left eye still acts up way too regularly, but I'm putting off doing anything (Jones Tube) for as long as possible. So I still dabble with Blephamide and Lotemax to temporarily put off anything drastic. Way back when I had my first plugs inserted, I was definitely not told of any problems which could result... I don't even know what type of plugs they were, etc. Anyway, I still wonder if I do have at least one plug in my lacrimal sac or somewhere near as I have soreness and feel a slight swelling in that area from time to time. Oh well, one day at a time...

[sazy123]

Im not conviced with this whole plug thing. One of them i can still see whether thats irratating the lid i dont no, the red bit in corner seems to have gone down now. The other one i cant see, so god knows if its still there. Its been 3 years.. I was considering getting flow controllers in the top ones but i think its a waste of time.. as i didnt notice much difference from inserting the temporary top plug except tear over flow on the first day. i really dont think plugs are as great as docs like to think. Judy, Skygoddess, rkralman im sorry you for bad experiances, your stories really makes me think its not worth the risk. I think ive heard more reports about them not helping and problems like falling out/migration and the unknown than ive heard plugs actualy helping peoples dry eye. But i have to make a decision about flow controllers by 2moz or maybe get these smart plugs removed.

[rkralman]

If I had a second chance, I would definitely...........

If I had to make the choice to have plugs all over again, I would NOT choose Smart Plugs for the fact that they migrate too easily and you cannot tell if they are in place or working effectively. Many folks are sensitive to the material it is made of which causes the swelling, redness and itching. As I said, one doc said I did not have plugs in my eye, and the next doc squeezed out three plugs so if you experience these symptoms, get another opinion about this so you do not leave it in there and develop scar tissue like I did!They are just too dangerous and the last surgeon I went to for my second DCR surgery feels very strongly that they should be against the law due to the overwhelming amount of surgeries he has to do in order to try to correct the damage done by plugs. Believe me, dealing with even severe dry eye is a cakewalk compared to the expense of having multiple surgeries and a permanent glass tube stuck in my eye for the rest of my life. I am just heartbroken and exhausted by the second failure of DCR surgery and feel I have no choice but to go ahead and get the Jones tube. Seems we all have a common thread and everyone is different but the last three specialists I have gone to say very adamantly: NEVER PUT PLUGS IN YOU EYES AGAIN! THE RISKS FAR OUTWEIGH THE BENEFITS! Also, FYI, I also had a traditional type plug with a cap on it migrate down my punctum so be very careful if you choose plugs that you go to a reputable doc who knows how to properly fit these! Best of luck to everyone!

[Judy]

I feel the same way about plugs, but try not to always voice this as they do seem to have helped so many people.

Rkalman, I am so sorry to hear of your trouble and that you will be doing the Jones Tube thing soon. Only because I am heading in that direction, do I feel I can relate... You must be having more severe infections than I and that is such a bummer. Mine can get worse at any time, but right now is semi-okay. When you get your tube in place, please let us know how things are going. I've read many good things about the Jones Tube and thank God it is an option for those of us who need it. What would the cavemen have done? Then again, they would not have been putting plugs in their tear drains, right? Take care! Judy ps - by the way, I had the type of plugs with caps on them too and they migrated as well.... never again. Actually I can't as one punctum is torn open to smitherenes and the other one scarred over a while after the last plug migrated to never never land (hopefully)...