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Old 09-24-2007, 10:00 AM   #1
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Dry Eye-Punctal Plugs

Last week I had 2 punctal plugs inserted-one in each eye , lower duct. I have had dry eyes for over 10 years. I am not using restasis although doc really pushed it . My pcp is not enthusiastic about restasis as it is so new and a immune modifier. So, I just went with the 2 plugs. While I may have some relief it isn't really much. I am wondering about adding 2 more plugs.
Has anyone done the plugs on both upper and lower ducts? The doc said something about more irritation possible with upper and lower plugged. Any comments?

 
Old 09-24-2007, 01:39 PM   #2
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Re: Dry Eye-Punctal Plugs

I just had the duct plugs inserted in both upper and lower lids this morning, so sure hope they don't cause irritation. I had no problem with the upper/lower temporary plugs. My eyes feel good this afternoon, so hope it lasts!

Interesting about Restasis being an immune modifier. I asked my opthamologist about it during our initial visit, but he said no, because it caused some people problems. Guess it's good he didn't prescribe it--I thought it was just 'cause he was pushing the tear duct plugs.

 
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Old 09-24-2007, 02:32 PM   #3
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Re: Dry Eye-Punctal Plugs

Hypatia-Would you follow up in a few days and let us know if the upper and lower plugs are working out for you? Whether there is any irritation and whether you are really able to cut back on the amount of eye drops you use. I am assuming that you were having to use drops alot since you had the plugs put in. As the plugs just in the lower are not really giving me much relief I am thinking about getting the top done soon. Did your doctor do a stain test to see how dry your eyes were or a paper strip test? My doc didn't do either.I have just read about both. About restasis, I had another opthamalogist who wasn't very impressed with it . Why my current optha. can't stop going on about it is odd to me. But, I am really not intersted in using it. My pcp is a brilliant doc and if he is negative on it that is good enough for me. I should add that maybe he wouldn't be negative on it for everybody, I have an autoimmune disease so maybe that is part of it. He doesn't want me to have any more drugs than I absolutely need to have. So, I am going along with what he says. Also, did your doc tell you to be careful about not rubbing your eyes because the plugs could come out? It's hard for me to remember not to do this , for example , when I am washing my face. In fact, I hope they are still in . I have to say when I look in the mirror I can't tell if they are still in or not, can you?

 
Old 09-25-2007, 07:10 AM   #4
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Re: Dry Eye-Punctal Plugs

Last night it looked like a film of moisture over one eye, but that seems to have resolved. I'll keep you posted and hope you share how your plugs are working. I can't see well enough to tell if the plugs are in, but try not to itch or rub. Still have to do baby shampoo scrubs. Never heard of the strain test, so will go research that, although it's a little late :-).

I think my dry eyes are due to inhalers/meds I use, plus reading and too much computer use. My doc says no--it's because it's so dry here in CO. At any rate, it's a pain. Plus I have early stage cataracts. Bummer.

 
Old 09-25-2007, 05:21 PM   #5
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Re: Dry Eye-Punctal Plugs

Quote:
Originally Posted by osteoblast View Post
Has anyone done the plugs on both upper and lower ducts? The doc said something about more irritation possible with upper and lower plugged. Any comments?
I had both upper and lower in my right eye. I never noticed the upper ones, but I always felt the lower ones if I moved my eyes all the way to the side. They helped some, but not as much as I would have thought. My eyes usually were driest in the evenings, and it didn't seem to help then. During the day, when I wasn't having problems, it was almost annoying because my eyes seemed wet all the time.

What was funny was that if I watched a sad movie it was very very hard to keep tears from welling up and rolling down my face. Normally that was not an issue, but the plugs made even the tiny tiny tiniest buildup of moisture a big fat tear. Since I'm a guy, this caused my wife to make a ton of fun of me.

ebmd

 
Old 09-25-2007, 08:31 PM   #6
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Re: Dry Eye-Punctal Plugs

Hypatia-it was the stain not the strain test. I am doing ok with the 2 plugs, now it's been approx. a week. But I still have the dryness that I hoped would go away. No discomfort really though. The refresh tears I use are drying on my lashes and resulting in a cakey sort of build up. Before the plugs, when I put the drops in , I just wiped away any excess with my fingertip.Maybe I shouldn't have done that- but it never resulted in a problem. Now, I don't do that since the doc said don't push along your lid or tug it in any manner. So, I don't catch the drip and it dries. I guess I need to dampen some kleenex and blot lightly that is all that I can think of doing. The way the doc said don't touch your eye area, she somewhat made it sound that it would be very easy to inadvertently pop the plug out by a tug.
Are you still having to use drops alot?? I have made an appointment in about a month to talk with the doc about putting the plugs in the top ducts as well.
Are you still using drops? If so what drops are you using? Are they caking in your lashes?
Sorry to hear about the cataracts. Did the doc say why you have these early?

Last edited by osteoblast; 09-25-2007 at 08:37 PM.

 
Old 09-25-2007, 08:34 PM   #7
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Re: Dry Eye-Punctal Plugs

Ebmd- the problem with the tearing sounds like a problem that I wouldn't mind right now. I guess it could get annoying. But, my eyes have been so dry for quite awhile that moisture would be something different and welcome.And, if the tear was only when you were tearing up with a cry then it wouldn't bother me at all.Right now I don't feel the plugs on the lower at all. Did you keep the plugs in your right eye? Are you also having to use drops alot?

 
Old 09-28-2007, 12:55 AM   #8
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Re: Dry Eye-Punctal Plugs

I had both upper and lower done 7 years ago. With all four it was a bit much. Tears constantly streamed down my face and it was embarrassing. Got the top ones taken out quick-smart. I've still got the bottom two in... I rub my eyes all the time and they still haven't popped out.

 
Old 09-28-2007, 01:49 PM   #9
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Re: Dry Eye-Punctal Plugs

Quote:
Originally Posted by osteoblast View Post
Did you keep the plugs in your right eye? Are you also having to use drops alot?
No, I didn't keep them, they fell out at some point. My eyes are better than they used to be, but after about 10 PM they are very very dry and I go to bed. Before bed, I use Genteal Gel Severe (the viscous stuff in a tube). I used to use drops a fair amount (the single use ones); I had no particular favorite, but mainly used Systane.

The thing I was always concerned about with drops was that perhaps my eye would get used to artificial ones and stop producing natural ones. Don't know if there is any truth to that.

You know what worked temporarily (10-15 minutes at a time)? This sounds gross, but I'd tug on a nose hair with tweezers. It affects a nerve that connects somehow to your eyes to stimulates tear production... Unfortunately, I did that so much that it no longer helps.

good luck,
ebmd

 
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