Punctal Plugs

[Lauren 007]

I may have to get punctal plugs in the next few months. What is the procedure like? Is there downtime? Thanks.

[Melissa W]

Hi Lauren,
It's pretty straightforward, quick and easy.

What is it like to get plugs? Does it hurt?
Punctal plugs are sold with a long tweezer-y looking thing used to insert them. Now, how they are inserted depends partly on what kind of plug they are, for example, some fit right into the top of the punctum (and you can see the caps in the mirror) while others are shoved way down into the canaliculum. But broadly speaking, here is what will happen: Your eye doctor will put in some eyedrops to anaesthetise your eyes. He’ll then use one part of the tweezer-y thing to poke into the puntum and stretch it out a bit. Once it’s ready, he uses the other part of the thing to push the plug into the punctum. Plunk! It’s there. On to the next punctum.
In some cases your eye doctor may have to wrestle with your punctum a little bit to get the plug in. It really shouldn’t hurt at all, but you know, that’s what they told me about my wisdom teeth before the five shots of novocaine and the footprint my dentist left on my face when he braced himself and pulled. If your eye doctor hasn’t done this very often, as was the case with me once, it might be a little uncomfortable, but that's unusual. Really. You should be just fiiiiine.
If you hadn’t already figured this out, the fact is that every time I’ve had plugs put in, it was not my favourite experience, but to be honest I think the anticipation is worse than the fact. My best experience with plug insertion was SmartPlugs, because with those ones they don’t have to stretch open the puncta the way they do with standard plugs. Didn’t feel a thing.
What happens once the plugs are in?
After the anaesthetic wears off, you may be sore from the insertion process. Some people also have a reaction to the plugs that makes them feel uncomfortable - this may even last up to a few days. If this happens to you, please don't despair, don't claw at your eyes and unless it's intolerable don't force your eye doctor to remove them - chances are, the discomfort will pass and in a couple of days you'll feel much better. On the other hand, if you see swelling or have constant pain, by all means call your doctor.
A minority may find that their tears pool up and run over after the plugs are in. There's even a fancy term for it — epiphora. (Now you can really impress your doctor by asking about epiphora before he even puts the plugs in, rather than give him the satisfaction of explaining it to you after you get it.) Personally, I have never had epiphora from plugs, but I know people who did or do. Some people experience significant enough benefits from the plugs that they tolerate the overflow as the price they pay for healthier and/or more comfortable eyes. Too much overflow can be either embarrassing or convenient, depending whether it’s happening during a job interview or while your great aunt is telling you all about her latest hospitalisation. But chronic overflow may be unhealthy as well as inconvenient, so by all means keep your doctor up to date on what's going on.

http://www.dryeyezone.com/encycloped...occlusion.html


Here is an overview of the different types available that you may want to read.

http://www.dryeyezone.com/encyclopedia/plugs.html

http://www.agingeye.net/dryeyes/plugsetc.php



Melissa