12 year old needs plugs

[KaeleysMom]

I have a 12 year old that has been on Restasis, and FreshKote for about 3 years.  We went to an endocrinologist 2 years ago and she didn't have enough (something) in her blood to detect Sjogrens at that time.  But she has a lot of symptoms of it.  So, we are waiting until it progresses to get a diagnosis.  In the mean time, we are treating her symptoms as they crop up.  Her mucus tears are doing great with the Restasis, but now her top watery tears are drying up super fast and she was constantly blinking.  So we put in temporary plugs that will disintegrate in a few days to see if permanent ones may help her out.  So far, she is loving it.  Her eyes don't feel dry and gritty and she isn't blinking abnormally.  My question is, if this appears to be working for her, should we go with the permanent ones?   Can they damage ducts?  I want to make sure we don't permanently injure her at such a young age.  Any advice would be helpful.  The doctor has put in plugs many, many times but hasn't really had to do it on someone so young before.

[KaeleysMom]

Are their concerns I need to be aware of when putting in permanent plugs?

[Patty]

I got great relief with plugs also. I'm not sure if mine are considered permanent. They can be removed, and it is possible for them to fall out, but I have not had them fall out yet (had them about 8 months). I did have one duct cauterized, which is permanent - I wouldn't go that route since your daughter is young and might have the situation change. Hopefully someone who knows more will post on this.

[eyeamdry]

Only your daughter's doctor is qualified to tell you what is possible for her.  He/she would know the possible problems that might come up.  We are all just rookies like you, Mom.  Also the doctor doing the plugging will have to be responsible for any problems that may occur.  I do know that scarring can occur from plugs being put in.  Two of my puncta are scarred shut.  Let us know what her dr says.  Best of luck to your little one.  Lucy

[gurs]

Ive had the temporary punctal plugs for over 6 years now..would start with that first. I myself would never get them cauterized.
Too afraid....

gursie

[KaeleysMom]

Thanks so much for feedback.  I posted here about 3 years ago when all of her symptoms started.  I love this forum!!

It's hard to figure out what to do when I don't have experience with this sort of thing.  Yet I love and am responsible for someone so young, who experience these symptoms.  I have a hard time grasping at why some children have AI diseases.  We've been told, if it's not Sjogrens then it is definitely another AI.  But is sure looking like Sjogrens.  Kaeley's temporary plugs will dissolve in just a few days.  The permanent ones can come out, but presumably only with doctors help. 

I didn't know about scarring.  Is it rare?  Is it worth the risk?  Also, I'm concerned about colds, etc. increasing bacteria in the duct causing infection.  Is this rare also?  Can you blow them out under pressure (like when you clear your ears over mountains)?  I just want to make a more educated decision when I decide whether to put them in or not.

I agree - I would NEVER cauterize at this young age.  I feel that is a decision she will be able to make for herself when she gets older.  That's an alteration that can never be changed.  And I don't feel that decision should be made by anyone other than the person themselves after they are entirely educated about it.

[gurs]

why does the plugs last only 3 days? mine are made of a plastic type material I think? My one fell out one time and that was it.
Ive had them for so long?

Gursie

[A66eyroad]

I seem to remember that there are two types -- the temporary kind that dissolves after a certain amount of time, and the more permanent kind that're made of silicone. Silicone plugs come in sizes, and if your doctor puts in some that're too small, or if they're placed in a child who then grows, they can sometimes fall out.

[KaeleysMom]

Hers will take about 4 - 5 days to dissolve.  I think the doctor just wanted to kind of run a test to see if Kaeley could see an improvement with them.  Then if it really did help, she would notice irritation again after they dissolved.  It will show if the permanent (silicone, not dis solvable) ones would help her out.  The test seemed logical.

[A66eyroad]

That's how mine were done, also, with the temps first, then the silicone. (I then had the cautery, which was done about 13 years ago. I only had the two lower ducts done, and it was the best thing that I ever did for myself!)

[KaeleysMom]

Well, it's done . . .  Kaeley has "permanent" plugs.  Hopefully this will help her out.  I just can't believe I'm doing this to my 12 year old!

Thanks everyone for your advice. 

[Patze]

Hi KaeleysMom,

I have all mine plugged, well three of them (one in my lower right will not stay in and it drives the opthamologist nuts).  Hopefully the plugs will work well for her, and will help her out (my eyes are the worst of my symptoms, so I sure do feel for your daughter).

Take care of yourself -

Patze

[gurs]

On a side note......my eye docs dont like to do all 4 plugs...I had it done and it caused all kinds of infections and it was gross.
He said they dont like to do all 4 because of increased infections. I only have had my lower ones done now with the punctal plugs. All 4 of them plugged would increase the tears, hence, making the plugs fall out easier? My eyes are still super dry, so im guessing thats why my plugs stay in?

Good luck though

Gursie