Punctal Plugs

The entire in-office procedure is painless and usually takes only a few minutes. As strange as it sounds just picture a healthy eye as a full sink with tears (instead of water) reaching up to the rim. Dry eye syndrome (DES) occurs when your eyes fail to produce the necessary quality or quantity of tears to protect and preserve the ocular surface. In this case the sink would be pretty empty. Those with DES do not have a sufficient amount of tears to adequately bathe the eyes and therefore often complain of irritated scratchy stingy and/or red eyes. In severe cases many even suffer from decreased visual acuity and fluctuating vision. Some patients will also complain of watery eyes which can be the result of the eye s attempt to replenish its inadequate tear supply.

In DES patients the problem is that an insufficient amount of tears remain on the surface of the eye. Usually initial treatment for dry eye is the use of eye lubricants or drops to replenish the lost tear film. These often need to be instilled from four to six times a day depending on the severity of DES. In some cases drops or ointments do not provide enough relief from dryness. In these situations your doctor may want to perform punctual occlusion. Puncta are the little openings on your eyelid margin that carry away excess tears into the tear ducts. If you look closely along the upper or lower eyelid margin about midway between the center of the eyelid and your nose you ll see a little white bump with a hole in it. There are two tear drainage ducts for each eye.

Punctal plugs provide a temporary or semi-permanent means of occluding the puncta allowing for the conservation of tears. Considered only in patients with moderate to severe dry eye punctal plugs reduce the outflow of tears and help keep the surface of your eye moist and lubricated. Think of a plug in the drain of a sink – the plug acts as a stopper so that the water has no place to go. It is the same thing with tears. As a result your natural tear film bathes the eyes for a longer period of time.

To determine the effectiveness of punctual occlusion a temporary collagen plug is inserted into one or both puncta in each eye. These dissolving plugs can last anywhere from 5 days to several months depending on the type used. If this proves successful patients may then be offered semi-permanent or permanent forms of punctual plugs. In most cases a small soft silicone plug about the size of a sesame seed is non-surgically inserted into the punctal opening. The entire in-office procedure is painless and usually takes only a few minutes.

If you think you are suffering from DES or feel that your ointments or eyedrops aren’t supplying enough lubrication contact our office about the latest punctal plug options.