Then, from wiping them so often, the one lower plug came out.
So now I have 2 uppers and one lower plug. The right eye has both plugs and is tearing badly.
The left is doing fine with just the upper plug.
I return to the doctor in a couple weeks. He was going to remove a set but now since the one bottom one came out, I'll ask him if I can just keep the two new upper plugs and that he remove the one bottom plug.
I did some internet research and found this:
Welcome to Dry Eye Talk!
So 4x occlusion is too much and 2x is not enough? Maybe time to investigate different plug brands and designs if you have not already? In particular, perhaps EagleVision's flow controller plugs (which permit more drainage than their standard plugs) in the lowers might make having upper plugs more workable? Mind you I don't have much experience at all with the flow controllers, it just occurs to me as something that "sounds sensible" for this kind of situation.
|There are several types of punctal plugs, which have
different properties and uses depending on the material
from which they are composed. They are commonly divided
into punctal (or punctum) plugs, which are placed at the
top of the puncta, with the tops visible and
intracanalicular plugs, which are inserted into the
canaliculus, and thus cannot be seen after insertion and
need to be flushed out with irrigation for removal. In
practice, both types are plugs are commonly referred to
as “punctal plugs”.
Collagen implants are dissolvable punctal plugs that may be used as a trial to assess if occlusion will ameliorate the patient’s symptoms and to rule out intolerable epiphora due from occlusion before irreversible punctal occlusion is performed. They dissolve within 4-7 days and do not cause complete canalicular occlusion. They are available in a variety of sizes and from a variety of manufacturers (see below for list of some manufacturers). Collagen implants may be used as a trial of punctal occlusion prior to more permanent treatment, for temporary enhancement of topical medications, for post-operative reduction of dry eyes and in the assessment of the effect of aqueous tear deficiency on ocular surface disease.
If he removes the one lower plug and I do okay with the 2 new upper plugs, then the situation will be resolved.
I hope that will fix everything and the 2 upper plugs will provide me with enough eye lubricant of tears so I don't have to investigate trying other types of plugs.
Again, all said and done, from my experience, I still highly recommend punctal plugs as a solution for dry eyes. Not having red eyes, not having physical discomfort from dry eyes, not having to use artificial tears and eye drops constantly is a huge plus. I use a computer at work and do a lot of reading documents with small print so it is imperative that my eyes are lubricated and maintained so they can perform their best.
On a side note, I turned 58 last month and my annual eye exam showed my vision has not changed for the last 2 years. I use reading glasses and bifocals at work, and recently got the trifocals for 3 purposes in one pair of glasses: reading, computer monitor viewing and distance.