Tear Duct Plugs


There has been a lot of talk about the tear duct plugs (Punctal Plugs) lately and I had meant to do this post weeks ago. It’s been sitting in my drafts so I figured this was a good time to go about it.

When my doctor first started talking to me about the plugs I couldn’t figure out why in the world I would want them. All my life I had thought the tear ducts is where the tears came from. So why would I want to dam them up if my eyes were already dry? LOL! It turns out that I had an incorrect understanding of what they really did. From what I have heard from others they thought the same thing so I don’t feel as dumb for thinking that now. 🙂

What the tear ducts actually do is let your tears drain into your nose. You have these ducts on the upper and lower lids. Most doctors start out putting the plugs in the lower eyes first. Your first set will dissolve in a week or two. They are supposed to last about two weeks, but they tend to not last as long for those of us with really dry eyes. These are the test plugs to see how you will adjust and if they work for you. They are not as expensive as the silicone plugs.

If the first set of plugs work then you move on to the next step. The silicone plugs. They come in different sizes and your doctor will try to pick the size that is right for you. I think they look like little tiny nails. It just takes a few minutes. He put some numbing drops in my eyes and popped them in. No pain at all.

I have really small ducts so my doctor tried the smallest size first. These irritated my eyes really bad and I was worried that I was going to have to deal with it or not use them. They kept sliding up out of my duct and I was constantly pushing them back in. They were rubbing on my eye and creating more problems. After about two weeks they both fell out.

I went back to discuss what we should do next. He wanted to put the next size up in. I was weary since the other ones rubbed my eyes so much. My thought was that if the small ones rubbed my eyes with that tiny little nail head wouldn’t the bigger ones be worse? He gave me the option of using the ones that go further down with out the nail head end. The problem with those is that if they bother you or you get an infection they are harder to get out and they can slide down further into the duct. I decided to try out the larger size.

The larger size is great. I realized that with the smaller ones the irritation was caused by them sliding out of the tear duct and rubbing on my eye. The larger ones stay in place and I can’t even tell that they are there! I do have to be careful since I tend to rub my eyes a lot. I check multiple times a day to make sure they are still there. My OCD on checking on them is getting better the longer they are in. I’m only checking on them a few times a day now. 🙂

For the first time in I don’t know how long I had glossy eyes! It was amazing. I was so bad at using eye drops. I was so used to the dry gritty feeling and just going on with my day. When I had the first plugs inserted the doctor told me I had an eye lash in my eye. He was like, “Don’t you feel it???” Ummm… no, my eyes always feel like that. I never know if I really have something in my eye or if it’s just the dryness. For the most part that feeling is finally gone! When I’m in a flare I do use the gel at night if I wake up and my lids are glued to my eyeball. If that happens for a night or two then I will just put the drops in before I go to sleep to avoid being woken up by it.

If you are still having issues with some dryness they can try putting plugs in the upper ducts also. I have decided to wait on that since I am doing OK with just the bottom ones. The day I had the Schirmer test my left eye was at 3 and my right eye was at 7. Dry, but not at 0.

The plugs do fall out over time. It is normal. You can decide to have your ducts cauterised later if you think it’s a pain in the neck going back to get new plugs put in. So far my second set hasn’t thought about falling out. I like the idea of know that they can be taken out if I want. Cauterizing will be a last chance, final choice if nothing else is working.

Well, that’s a little bit about the plugs with my story tossed in. If I had known someone who had the ducts when I went in I would have felt more comfortable making the decisions. Especially when I was trying to decide on getting the next size up or not. I hope in some way this helps someone else out there that is trying to decide what to do.

Have a wonderful day today!!!

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5 thoughts on “Tear Duct Plugs

  1. I feel more edumacated now. 🙂 I always thought tear ducts produced the tears too! LOL Thanks for the info. I’m really learning a lot about Sjogren’s. Wish I could submit it for my CE credits. LOL

  2. I read about these and frankly, the idea of eye plugs scared me to death. The way you described them has made me think that I should bring them up to my eye doctor at my next appointment.

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