My wife dives regularly with perforated ear drums. She had weak spots in her eardrums from tubes placed in her ears as a child. While diving Stingray City, one of weak spots ruptured - blew off diving the rest of the trip. On return, she visited an ENT that (in my terms) super-glued patches over the weak spots on both ear drums. One held, the other created a flap that to this day will occasionally vent air. Since moving to NC, she has visited an ENT based on a referral from DAN. The doctor advised her of the risks, but gave clearance to continue diving. 400+ dives later, no problems. She still has an occasional "vent," but has not experienced any adverse issues with infection. Our only theory is the flap prevents water from getting in, but allows air out.
She tried using ProPlugs, but had problems keeping them in her ears throughout a dive. After several dives where they came out dangling on the strings (or lost), she gave up on them.
It is still rather disconcerting to see bubbles or hear air whistle out, but there is no keeping her out of the water...