Do Punctal Plugs even work?
The simple answer is...they can. For people with true aqueous deficient dry eyes (due to Sjogren’s Syndrome, among others), plugs can be a really great option. However, we have to be really careful with plugs because with dry eye, there’s always inflammation in your eyes so you have to get rid of that inflammation first. To do this, you have to clean up your eyelids, you have to get Demodex treated and make sure your eyelashes are clean before you put plugs in. If you think about it, punctal plugs keep tears in your eyes, which is a good thing unless you have bacteria floating in your tears. Overall, there is a place for plugs and they do work for some people, but they’re not a great option for others. It's best to speak with your doctor, who knows your eyes best, and see if they're a good fit for you.
How come my eyes are developing sensitivities to treatments and eye drops that used to help?
Every choice you make in life is going to change how anything works and can affect how drops and treatments react with one another. For example, we would not want you on antibiotic eye drops long term due to developing resistance. Although many of the drops out there do not have preservatives in them, you have likely changed something in your lifestyle that has caused a different reaction for you. Even with Restasis and Xiidra, we always let patients know that they may have flare ups occasionally. When this happens, we prescribe short-term steroids to knock down inflammation. Another thing to consider is the number of drops being used. Sometimes, if you’re using too many things at once, this can cause sensitivity issues. Basically, know that any change you make in life can cause an eye drop to begin working or quit working, and take a look at how many drops you're using. They may be reacting with one another and it may be a good idea to cut back!
Do ointments and thicker drops negatively affect your meibomian glands?
No, they should not. A lot of the reason we use drops and gels like that is to protect the eyes at night, because at night your eyes can get really dry. Some people sleep with their eyes open as well, and an ointment or thicker gel can coat the eye at night. If you are keeping your eyelids really clean by using our spray or another eyelid cleanser in the morning and evening, these thicker drops or ointments should be fine to use.
Are you having any issues with the eye drops you're using? Have you found one you really like? Let us know in the comments below!
Drs. Travis and Jenna Zigler