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Old 04-13-2003, 04:05 PM   #1
Daisy22
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Post help-punctal plug problem

I got punctal plugs put in my lower tear ducts on Saturday afternoon. I had the temporary ones put in a couple weeks ago, and yesterday my eye dr put in the permanent ones. My eyes were fine until yesterday evening, when they started becoming very irritated. My right eye is a lot worse than my left eye. I can feel the top of the plug rubbing against my eye and the inner corner of my eye is completely bloodshot. I can sometimes feel something with the left eye and it is a little red but is not as bothersome as the right eye. I can see the tops of the plugs and it looks like the right one is out a little further.

Is this normal, should I be feeling them? My dr said that they are supposed to stick out a little, but they are really annoying. Am I just supposed to get used to this? I plan on going to the eye dr first thing tomorrow morning. I'm hoping she can push them in further, but if not will I get used to them. I'm thinking that I might want them removed, they are awful right now!

Thanks

 
Old 04-13-2003, 06:35 PM   #2
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NO, you should not be feeling this much discomfort. Yes, for the first few days you are supposed to be aware that something is in there, but it should not cause the problems that you are describing. When you look from side to side, it is expected that you will feel something in the ducts for a few days. It is also normal to be able to see something shiny and clear where the tear duct is, but you should not be able to see the plug sticking out at all. It should definitely not be causing any pain/discomfort or redness.

RUN, don't walk to the dr. I had a problem with a punctal plug too.... it moved and was apparently sticking out a lot and it caused an abbrasion in my eye. My dr immediately removed all of my plugs. He said that they are not supposed to do that, but it is possible in very rare cases (that's me... meet Ms. Rare Case) . He eventually wound up having to cauterize all 4 of my tear ducts. They are now permanently closed without any sort of artificial plug to cause irritation. The plugs do have a huge benefit for the dry eyes, but if they are going to irritate you that much then it is not worth it. Cauterization might be your best bet if you find that the plugs help with the dryness but your eyes can't tolerate them. I would try to give the plugs some time though, but you have to go back to the dr and get this fixed.

Also, if these plugs are not staying in, they may not be the right size. You may need a slightly smaller or slightly larger size. With me, my dr was always able to get the plugs all the way into the ducts, but eventually they tear ducts stretched and grew around them and they continally fell out and I needed bigger sizes. Sometimes they didn't stay in for more than a few hours! It got to the point where there was no bigger size! Your dr may have started with a size that is too large for you, and the plug may not be all the way in the duct, which can cause the problem you are describing. Or, it might be too small for you which might have caused it to move out of the duct. Or size might not have anything to do with it at all. Definitely go back to your dr. In the meantime, use plenty of preservative free artificial tears to keep the eye lubricated and comfortable.

[This message has been edited by purple2067 (edited 04-13-2003).]

 
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Old 04-14-2003, 08:52 AM   #3
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Quote:
Originally posted by Daisy22:


Is this normal, should I be feeling them? My dr said that they are supposed to stick out a little, but they are really annoying. Am I just supposed to get used to this? I plan on going to the eye dr first thing tomorrow morning. I'm hoping she can push them in further, but if not will I get used to them. I'm thinking that I might want them removed, they are awful right now!
Thanks
No reason to panic. Go see your doctor promptly. Sounds like the plugs have dislodged. You may need some larger plugs that stay in place better. The plugs should not be sticking out at all. Cauterization is probably not an option for you at this point. As it is reserved for chronic or very severe cases of ocular surface disease.


 
Old 04-14-2003, 11:53 AM   #4
Daisy22
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Thanks for your replies.

I went to my eye dr this morning. She said that the caps on the plugs are angled out. The caps should sit flat, but depending on the shape and angle of the tear duct the caps can become angled. They apparently both are the same, but only the right one was bothering me. She just removed the right one and put in some antibiotic drops.

She said that there are plugs with angled caps, and that they can order one for me and put that in.

But I don't know how I feel about the plugs to begin with. To me they are more aggravation than they are worth. I never really knew my eyes were really dry, but my dr said they were and that I may not know because it is normal to me. That I could have a lot of benefit from plugs. I didn't notice any difference with the temporary ones. My dr was disappointed with my lack of benefit but she said that my eyes were healthier and less dry with the plugs. Maybe the permanent ones will be better. Did anyone have better luck with the permanent plugs than the temprorary ones?

Thanks again

 
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