Has punctal occlusion helped anyone here?
If so, to what degree?
An eye specialist highly recommended I get this done, but with a score of zero on the Schirmer's
I don't know what tears this would prevent from draining, since I have none. ???
Yes, it has helped me tremendously! I was miserable until now had it done. I started with plugs but then opted to do the cauterization so it would be permanent and i wouldn't have to worry about plugs falling out.
I recommend starting with the plugs first and seeing if you see a difference. I only felt the difference when I had all four plugs in but the relief was immediate. I had a zero score in one eye and I think one in the other. So virtually no tears. But the occlusion helped. Even with no tears, the artificial tears will stay better on your eyes.
Hope this helps.
Liz D.
Thank you Liz, this does help me make a decision!
My eyes are so red and irritated I think I'm scaring people....
It would be great to get some relief.
He does want me to start out with the plugs for a trial, but only 2 in each eye.
Do you know how long the plugs last?
I had my lower tear ducts cauterized shut in dec. 2010 after I tried temporary
plugs for a few weeks and had good results. I too had a nearly no tears on my schirmers.
My eye dr. said that I only needed the lower tear ducts closed d/t the upper tear ducts just
didn't drain as much tears away as the lowers do.
.
Also, you have to consider that when you do apply eye drops, that with your ducts closed
the drops stay in your eyes longer...they don't drain away.
I have been using Xiidra for 2 weeks now and so far I do notice an improvement. I do not
notice a funny taste in my mouth after using them b/c my tears ducts are closed, so no
draining into my throat/mouth.
shelly
Thank you Shelly!
How long do the temporary ones last?
Xidra isn't available where I live yet, but when it does become available (within a year they tell me) I'll give it a try.
My eye dr put in what he called dissolvable ones....I think he said they dissolve
in a few weeks. I am not sure if these are the same as the ones people call temporary
plugs.
shelly
Sharon, for some reason, my plugs kept falling out. I was going back to the eye doc every couple of days to have them reinserted. I don't know what kind they were or why that kept happening. But that is why I opted for the cauterization and have never regretted it.
Liz D.
Sharon:
I had temps for approximately 3 weeks before dissolving, then went to permanent plugs (bottom only) and have seen significant improvement. Chose not to try cauterization. Also use Restasis.
Deb
I am thinking I heard that the plugs come in different sizes,. If you have a size that is too small that may be why they fall out. Just wondering. Maybe someone could fill me in on this. Irish
Thank you all for your input.
Now I'm thinking I may need to do this with a specialist who's nearby and readily available to assist if complications occur such as them falling out.
What exactly is the difference between "permanent" plugs and cauterization?
I had it done a couple of years ago. It was a life changer for me. I went from being miserable to just using drops a couple of times a day on most days. I only had the lower ones done. For some reason I couldn't handle the plugs. They kept popping out.
Cauterization is when they actually burn the puncta shut. Permanent plugs are ones that don't dissolve but they can be taken out if needed. Some people have success with them staying in but mine kept falling out. That's why I went with the cauterization. You should try the plugs first.
Liz D.
Thanks gals,
Was the plug insertion or cauterization painful?
Plug insertion is not at all painful. Cauterization is only painful because of the Novocain needle you get first. But it is only a pinch and you don't feel the procedure. Recovery was not bad either.
Liz D.
Plug insertion was not painful, my permanent plugs have been in for 5 years with absolutely no problems.
I've had plugs on the bottom for over 5 years. When they finally found the right size, the plugs have stay in. I've had the tops ones done for about 2 years now and they are still in.
Thank you all for sharing your experiences.
This has been very helpful!
I take salagen for dry eyes and mouth. I had plugs put in. They worked really well and eventually fell out, but by that time the combination of meds fixed the eye dryness.
Thanks bloodless, what meds helped your eye dryness besides the Salagen?
Well, salagen is specifically for dryness, but drugs I take for sjogren's include plaquenil, gabapentin, tramadol and azathioprine.
Evoxac is a drug I've taken in the past for dryness. It didn't have a generic, so I switched to salagen.
I can't tolerate Salagen or Plaquenil.
I wanted to try Evoxac but it's not available where I live.
Try the temporary plugs first .. or go straight to the permanent ones that can last up to 10 yrs or more.
I used the temp ones for about 2 yrs, and 6 months ago one of them kept falling out, so we put the permanent one in. I loved it!
So I finally got the temp one replaced with a new permanent one last week in the other eye. I'm so happy they are OK for me. The perm ones are WAY easier to put in because they are shorter.
I had a "shallow" tear duct so the temp ones were too long for me.
Give it a whirl!
PS .. I would try the plugs before the occlusion... that way you will know if it will actually help .. plus it won't be PERMANENT.
PS PS .. The temp ones last 6 months at most.
Thanks Jazz, just ordered the plugs today!
Cool... you have to order them?
Yes, the eye specialist (a prof. at a local hospital) wanted me to order them from a specific company and
then bring them to him and he'll insert them.
Oh OK. I had never had that experience.
Ordering them and bringing them in? Weird. My ordinary eye doctor put mine in. Also, she had to make sure got the right fit. If you have to order them and bring them in, how are you supposed to know they fit?
The doctor told me exactly which size to order and supplied a form.
I hope he was right because they were expensive!
I guess I'll find out next week when he puts them in.
So I had the plugs put in today and I'm a bit confused.
I had only ordered one pair which the doctor inserted in the bottom tear duct of each eye
but told me it wouldn't do anything for me since I also needed the upper tear duct plugged
to experience any change. Looks like he was correct, as I don't feel any improvement at all.
I know many here did see change with only the bottom plugged.
How is it that nothing at all has changed for me?
Even the artificial tears still drain quickly. :-\
You may have more severe eye dryness like myself than the others who only needed two. I did not get any relief until I had all four plugs in! I think you'll see a difference then.
Liz D.
Thanks Liz, that gives me some hope!
I just got both lowers plugged on Friday and haven't noticed a significant different in moisture. On top of that, I sometimes feel like I have a wonky contact in my eyes. Is that normal? Can you feel the plugs?
Also, how do upper plugs help if gravity makes tears go down the eyes?
Sunshinedaydream,
My ophthalmologist said when the bottom plugs are in, the top puncta automatically work harder to suction and drain the tears off your eye. When all 4 plugs are in and there is no drainage at all, any tear or eyedrop will stay on your eyes resulting in much more comfort.
Also, when I had plugs before the cauterization, I never felt them so I don't know why yours feels like a contact. Could your plugs be too big?
Liz D.
Thanks for the information, Liz. I didn't know the top punta suction so that makes sense if that's the way it works.
My left eye was fine on Friday after insertion and good on Saturday. It started crapping out yesterday and so dry today I am using steroid drops, so that is no improvement. In addition, when I look in one direction with my eyes before turning my head, I can feel a stabby pain of the plug in the opposite eye. You did not feel yours at all? How about you, Sharon?
Sunshine- I'm having the exact same experience as you!
I do feel them at times, especially when looking sideways
and my eyes have become irritated, although they game me prescription drops
from day #1 to prevent infection.
What to do?
My guess is that if we can feel their presence on the eye itself then they are perhaps too big?
Sharon, I called my doctor yesterday and she just returned my call this morning. She said the foreign body sensation is not uncommon. She also said plugging the bottom doesn't make a difference in dryness for many people, but adding the top plugs does, even often causing too much tears to accumulate. If the result is too much tears, the bottom plugs are changed to ones that provide some drainage.
She also said if the foreign body sensation is too bothersome we can try putting in something that can't be felt. What? Why not do that in the first place? Grr.
I decided to have the uppers inserted and we'll talk about what to do about the lowers. I have an appointment this morning and will let you know how it goes.
Thank you Sunshine, this is such important information!
I tried contacting my doctor today and had no success in doing so.
I still wonder if the fact that we feel the plugs in our eyes at times doesn't mean the size is a bit off
as we wouldn't be feeling them if they weren't actually touching the eyeball in certain eye positions.
What "can't be felt"? I'd love to know! Mine are made of silicon.
And yes- why not begin with the best they have to offer?
I'd also consider plugging the upper ducts, but right now the ones I have in are causing irritation.
Looking forwards to your update!
I got the top plugs put in and I'm feeling like, "Wow, someone turned on the faucet! This is awesome!" My right eye is in heaven with tears even pooling on the bottom. My left eye, which has consistently been the worst, is also pooling a bit. I've had them in for 10.5 hours now and haven't felt the need to use any lubricating drops. Normally I'd be using drops many times per hour in each eye all day long. I wish I had tried the plugs sooner!
The doctor said the foreign object stabby feeling is not because the plug is too big.
I still get the stabby feeling on the bottom, but not as much as when my eyes were dry. I also feel a little stabby on the top, but not as much as the bottom. The moisture benefit is worth the minor irritation which I will have to adjust to. It really only happens when I lead my turn with my eyes instead of my head, so I'll be more cognizant of my movement and try to create a new habit of swiveling my head more.
I misspoke in my prior post. If the top plug results in too much tear accumulation, the top plug (rather than bottom plug) will be replaced with a plug that has a hole or holes to moderate titration.
Turns out the plug option that "can't be felt" is puncta cauterization which would not be the first line of approach. If my plugs stay in for an extended period like others reported, I won't cauterize because I'm a very wimpy patient. :)
How are you coming along, Sharon? Did you get in touch with your doctor yet? Also, thanks for starting this thread. My current doctor recommended plugs a few days before you started the thread, and the comments convinced me to give the plugs a try even though my prior doctor said they wouldn't help due to my low amount of poor quality tears.
Sunshinedaydream, I'm so happy for you. I know that feeling of finally getting some comfort. Unfortunately there are some of us who need all 4 puncta plugged in order to have some relief. From time to time my left eye overflows with tears but I prefer that to the dryness! Hope Sharon can get same results!
Liz D.
Thanks for your update Sunshine!
Such wonderful news!
The plugs aren't bothering me much anymore so I stopped trying to track down my doc.
Not helping but not hurting.
So glad my post helped you get treatment!
Are your eyes white now with all the tears (just assuming they were red without like mine)?
How was your Schirmers score before?
Mine is zero so I don't know if I could get the same results as yours
but thanks to you comment I will try! :)
Thank you, Liz. Yes, I am getting some overflow too, but I'll also take that over dryness. So relieved my worst symptom is addressed. Still dry mouth and nose, plus other ailments but it's good to have improvement in one area.
Sharon, I had very low Schirmers and fast evaporation so my first eye doctor said plugs wouldn't help because there wouldn't be anything to collect. My eyes were never red, but often felt like they were. At the worst, felt like I had pink eye (conjunctivitis) but still always white. After a couple of years, I went to a second eye doctor last month and she said to try plugs before moving on to something else "otherwise we'll always be curious." Well, I wasn't curious at all due to what the first doctor said, but decided to get them after reading this thread regarding eye drops stay in longer. Bottom plugs didn't really help but the addition of top plugs has been life changing.
Keep us posted about how you're coming along.
Sharon,
My schirmers test was zero as well, but having the 4 plugs made a huge difference. Even my ophthalmologist can't believe the difference and how well my eyes are now.
Liz D.
Sunshine and Liz- Thanks for your responses, I'll be getting the top plugs inserted in the upoming weeks.
Strange how my eyes are always pinkish or red though when others' don't seem to be.
Leads me to fear my tears are inflammatory, in which case I don't know what result I'll get if they remain on
the eye surface longer.