Upper permanent plugs didn't fit.

[smb43432]

Is this normal? My doctor said he ordered medium and small. He said he would have to order extra small plugs. Is this out of the ordinary? should i bother getting them if the hole is that small? My dry eye problem has gotten a lot better and I can actually wear contacts now a days but they still get uncomfortable after a while.

[bassfan]

If insurance pays for it, it can't hurt I guess. Otherwise it can get expensive. I know when I went from 2 to 4 plugs it made a world of difference. I was dabbing every five minutes when I had 4 plugs in.

[kitty]

I have one of four puncta that is extremely tiny. Luckily my doc had all sizes of plugs in stock or I would have been in the same boat that you are. I can tell you that 4 plugs made a difference for me, when two really did not. I'm still dry and still can't wear contacts for more than a couple of hours, but the burning pain is not incapacitating like it was. If you have insurance, go for it!

[smb43432]

bassfan, what do you mean you were dabbing? overflow? because i had overflow to and im kind of worried about that.

[bassfan]

Ya...overflow of tears. I don't think its anything to worry about if thats what youre talking about. From what I hear, it sounds like a lot of it calms down after a couple weeks. Some of it might be reflex tearing as well with the foreign bodies in your eye. I only had 4 surface plugs in for a couple days until one upper fell out. The next day at work drove me insane with one wet eye and one dry eye...so I did some tweezer work and pulled the other upper out. Im waiting for my semi-useless local doc to get in the plugs I want and im going to try four plugs again and hopefully keep them in for a while this time.

[kitty]

I just want to share some food for thought with all of you considering plugging all fours. Tear overflow might not always be due to an excess of good tears. Any irritation that causes increased tearing (allergies, prolonged computer use, onions, etc) can result in tear overflow. Remember, there is no place for the majority of the tears to go once you have all four plugged. It may become a matter of how much over flow you can tolerate. Also remember that plugs will not prevent 100% of the tears from draining. You could conceivably have two eyes quadriplugged but because of slight differences in the sizes of the puncta, (or for other unknown reasons), you could have a significant overflow problem with one eye but not the other. That was the case with me. I dabbed one eye, the other eye tears streamed down my face constantly. They were not comfortable tears either. I now have 3 plugs. I just want you to have realistic expectations. If you have significant overflow with the standard temporary/short term plugs, you might want to consider the flow controller plugs instead.

[bassfan]

If you have significant overflow with the standard temporary/short term plugs, you might want to consider the flow controller plugs instead.

Thats actually what Im trying next...two flow controllers, two total occlusion.

[Jade9923]

Even the smallest amount of tears draining from your eye due to the plug being not snug enough can make the difference between comfort in that eye or not.

I'll tell you a story. The first time I got a plug in the upper punctum of my left eye, I had a similar problem. The bottom had already been plugged. I wasn't getting a lot of comfort from adding the upper plugs. My doctor looked at the upper plug and said it looked to fit snuggly and almost dismissed it thinking there wasn't anything more we could do in terms of plugs for that eye. But because she is an awesome doctor, she said lets do a test. She kept the plug in the upper punctum and put some sort of drop with yellow dye in that eye and sent me to wait in the waiting room for a half hour. After a half hour I went back in and she told me to blow my nose. (gross I know) I blew my nose and you could clearly see the yellow dye on the kleenex. That proved to her that the plug was not snug enough because the yellow dye was able to drain down the punctum. It even surprised her. Anyway, the result was that she replaced that upper plug with a larger plug and it made ALL the differnce in the world to my comfort.

I tell this story a lot because it is such a good example of how tedious this dry eye problem is. It REQUIRES a doctor who first and foremost cares and understands how painful dry eyes can be. I feel safe in saying that probably 99 percent of doctors would have simply said, the plug is fine, it looks snug and sent me home.

It also illustrates to those people who are new here how rare it is to find a doctor who is willing to try many things before dismissing the problem. This dry eye business is a time killer for doctors. I remember in the early days when I first started with this doctor because my last doctor just blew me off and told me to just keep using gels in my eyes, the new doctor would spend about 45 minutes each visit with me, trying things and LISTENING to me. I remember time after time walking out of room and looking at a room full of other patients waiting to be seen by her. SHE TOOK THE TIME. She was a caring doctor who was first of all very smart but secondly, wasn't going to give up until exhausting all the options.

In fact, the very FIRST problem she found was that all my mibomiem glands were so plugged they they were nearly almost scarred shut! Now checking those glands is a pretty BASIC thing any opthamologist should do when you complain about dry eyes. The doctor I saw before her, never found this problem. He was the one who said to just continue to use the gel. He was also known as a top rate doctor and surgeon! He was anything but top rate with my problem. HE DIDN'T HAVE TIME, DIDN'T WANT TO TAKE THE TIME AND HAD MUCH BIGGER FISH TO FRY DOING 30 cataract surgeries a day making him a ton more money rathar than wasting his time on a dry eye patient who made him no money and just ate up his time.

I'm passionate about my stories because I want to save others the pain I went through. You have to look at the big picture and be skeptical of any doctor who dismisses your problem too easily or too fast.

[Dot]

Hi all,
I have had the 90 day plugs in now for almost 3 months. It has been a huge relief for me. I still wear my tranquileyes for lagopthalmos and use liguigel at night and still using and liking the restasis.
My problem is that my doc doesn't like, hence do the permanent plugs due not being able to remove etc. if there is a problem. He didn't even know about the 90 days until my optomoterist faxed him the info and he acutally purchased them and put them in on May 11th. He also admitted to me probably "knowing more about DES than him"!!! Scary!!
The optometrist who sent this info to this surgeon is now saying that 6 months out if I am still dry the next option is cauterization because doing plugs again is putting off the inevitable...
I want your opinion please.
Thanks.

p.s. I have posted replies/threads and not been able to find them on the website to read a response. What am I doing wrong? Could you send me a private message and that will be easier to track?

[Rebecca Petris]

p.s. I have posted replies/threads and not been able to find them on the website to read a response. What am I doing wrong? Could you send me a private message and that will be easier to track?

Hi Dot,

Here's a tip: Use the search button at the top - click on Advanced Search, then type in your username in the username field. It will give you a list of everything you've posted, starting with the most recent, so you can find any threads in which you have posted.

Also: If it's been a few weeks since you posted something, it may have been "filed". I go through the Open Forum every so often and move threads to topical archives to make it easier to find things. I leave a "pointer" in the Open Forum though so that you can still see the thread title there and you can click from there to get to the thread.