Punctal Plugs for Dry Eye

What are punctal plugs?

Punctal plugs are small medical devices used to treat dry eye syndrome, a condition characterized by insufficient tear production or increased tear evaporation or both. Dry eye syndrome can lead to irritation, redness, and a feeling of dryness or grittiness in the eyes. These devices are designed to be inserted into the tear ducts (puncta) of the eye lids. The puncta are tiny openings located at the inner corners of the upper and lower eyelids. The plug is the size of a grain of rice and may be inserted into the lower ducts, the upper ducts or both.

What is the purpose of punctal plugs?

The primary function of punctal plugs is to block these ducts, thereby preventing the drainage of tears from the eye surface, which can help maintain surface moisture and improve eye comfort by relieving burning, itchy and red eyes.

When are punctal plugs an option?

The use of punctal plugs is considered when other treatments for dry eye, such as artificial tears (eye drops) or medications, have not provided sufficient relief. They are particularly useful for individuals whose dry eye condition is primarily due to tear evaporation or inadequate tear production. By keeping more tears on the surface of the eye, punctal plugs can alleviate the symptoms of dry eyes, improve visual clarity, and enhance overall eye comfort.

Your Union Square Eye Care doctor my suggest putting these special plugs into your tear ducts to help you keep tears into your eyes to treat your dry eyes when other treatments have failed to relieve your symptoms. Temporary plugs may be recommended so you can try out how they work for you.

What are punctal plugs made of?

Punctal plugs are made from a variety of materials, including silicone and collagen. They can be temporary or permanent. Temporary plugs are usually made from collagen and dissolve over time, lasting from a few days to several months. They may also be used to keep the eyes moist after having refractive surgery such as LASIK.

Permanent plugs are typically made from silicone or other non-dissolvable materials. They are designed to last for years and can be removed by your Union Square Eye Care doctor if needed.

How effective are punctal plugs for treating the symptoms of dry eye syndrome?

The effectiveness of punctal plugs varies from person to person. Many individuals experience significant relief from dry eye symptoms, noting a decrease in eye irritation and an improvement in eye comfort. However, as with any medical treatment, results can differ based on the underlying cause of dry eye, the individual’s response to the treatment, and whether any complications arise. Complications are rare but can include plug migration (movement of the plug from its intended position), infection, or irritation.

What is the procedure to insert punctal plugs?

The procedure to insert punctal plugs, also known as punctal occlusion, is a relatively straightforward and minimally invasive process typically performed by an ophthalmologist or an optometrist in an office setting.

• First, your doctor will evaluate your eyes to determine the appropriate size of the plug needed. Then an anesthetic eyedrop is applied to the eye area to minimize discomfort. Sometimes, the puncta may need to be dilated (gently widened) to facilitate easier insertion of the plug. This is done using a special instrument or dilator, but not all procedures require this step.
• Using a fine, sterile instrument, your doctor gently inserts the punctal plug into the punctal opening. Plugs can be inserted into the puncta of the lower eyelid, the upper eyelid, or both, depending on the needs of the patient.
• Once the plug is inserted, minor adjustments may be needed to ensure that it is properly positioned and comfortable. The plug is designed to fit snugly within the punctal opening, blocking the tear duct to prevent tear drainage.
• After insertion, your eye doctor will examine the eye again to confirm that the plug is correctly placed and to check for any immediate reactions or discomfort.

The entire procedure usually takes just a few minutes per eye and is generally painless, thanks to the local anesthetic. No stitches are required, and patients can typically resume their normal activities immediately after the procedure.

When your Union Square Eye Care doctor diagnoses dry eye disease and you have tried other treatment options such as artificial tears and prescriptions eye drops and have not found sufficient relief, ask about Punctal Plugs. They are safe and effective.

Union Square Eye Care provides punctal plugs as a treatment for persistent dry eye. Our skilled ophthalmologists, with offices in Union Square and Harlem, serve patients from Greenwich Village, Soho, and Midtown Manhattan, offering this minimally invasive option to help retain moisture and improve comfort.