When patients report dry eyes, the first step is usually figuring out what might be causing the issue. It could be things like age, medications, or the use of contact lenses. Once these factors are identified, they can be avoided or managed. However, if these steps don’t help relieve your dry eye disease, other treatments may be recommended, such as the placement of punctal plugs.
What are punctal plugs and how are they used in treating dry eyes?
Punctal plugs are tiny devices inserted into the tear ducts to block tear drainage. They are no bigger than a grain of rice and often made from safe silicone materials. These plugs help keep moisture on the surface of the eye, providing relief for those suffering from dry eye syndrome.
Tear duct plugs have become popular as a treatment option for dry eye syndrome because they work well and are minimally invasive.
How do punctal plugs work?
The primary function of punctal plugs is to conserve the eye’s natural tears by blocking the tear ducts where tears drain. The lacrimal glands, located by your eyebrows, help ensure there are enough tears to keep the surface of your eyes moist. When you blink, your eye’s tear film moves the tears to the inside corner of your eye. Here, on each of your upper and lower eyelids, there are puncta. These act as drains for both natural and artificial tears. If puncta drain tears too quickly, dry eye syndrome can occur.
Punctal plugs, also called lacrimal plugs, can be placed within the drains to help prevent the tears from leaving too quickly. As a result, the surface of the eye stays moist longer, which alleviates many symptoms of dry eye, including irritation, burning, and redness.
The proven efficacy of punctal plugs
The use of punctal plugs dates back to the early 20th century, with significant advancements in the 1970s and 1980s. Early versions were less comfortable and less effective, but modern designs have greatly improved their effectiveness and comfort. The introduction of silicone and other advanced materials has made them a popular and effective treatment option for dry eye syndrome.
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Types of punctal plugs
There are two main types of punctal plugs: temporary and permanent. Temporary punctal plugs are often used after LASIK surgery to prevent dry eye. But they are particularly helpful in determining if permanent punctal plugs will be effective. Generally, they are collagen plugs and are designed to dissolve within a few days to months. If temporary plugs help with dry eye and don’t cause watery eyes (epiphora), you might be a good candidate for permanent plugs.
Permanent punctal plugs are typically made from silicone and designed to last indefinitely. However, even permanent plugs can be removed if necessary. Permanent plugs can be inserted into the punctum or the canaliculus. Punctum plugs sit almost on top of the duct while intracanalicular plugs reside deeper in the drainage system. Your eye doctor can help you decide which type of plug is best for your eye condition.
How are punctal plugs inserted?
The procedure to insert punctal plugs is quick and minimally invasive. It is usually performed in an ophthalmology office. The doctor will use a drop of a local anesthetic to numb the ocular surface before inserting the plug. They may also apply a lubricant to help the plug go in easier. A special tool is used to carefully place the plugs. Usually, plugs are only inserted into the two lower eye puncta, but all four can be plugged if necessary. Once the plug is in, you may be asked to blink a few times to make sure it is securely in place.
What are the benefits of punctal plugs for dry eyes?
Punctal plugs are effective at treating dry eyes in people who don’t produce enough tears, have low-quality tears, or whose puncta drain too quickly. The punctal plugs procedure is simple and less invasive than surgery. Many patients don’t feel them. Those who do initially feel a sensation often adjust quickly.
It’s also reversible; permanent plugs can be removed if necessary, and temporary plugs dissolve naturally. Additionally, punctual plugs are versatile, meaning they can be used with other dry eye treatments like prescription medication or eye drops.
Why choose Asil Gaur Eye Institute for your dry eye treatment?
If you are experiencing dry eyes, it’s important to understand the condition and seek appropriate care from our world-class ophthalmologists. Punctal plugs for dry eye can be an effective, minimally invasive treatment that can improve your eye health.
The doctors at Assil Gaur Eye Institute are experts at treating and preventing dry eye as well as offering truly world-class eye care and vision correction. Specializing in LASIK, cataract, cornea, retina, and glaucoma treatments, at AGEI, you will experience state-of-the-art medical facilities that bring together revolutionary technologies with the most experienced doctors in ophthalmology. Our goal is to help you achieve your personal best vision.
To request a consultation, please make an appointment online or call us at 866-945-2745.
We are conveniently located for patients throughout Southern California and the Los Angeles area at locations in or near Beverly Hills, Santa Monica, West Los Angeles, West Hollywood, Culver City, Hollywood, Venice, Marina del Rey, Malibu, and Manhattan Beach.
FAQs on Punctual Plugs
Are there any risks associated with punctal plugs?
Punctal plug insertion comes with the risk of eye infection, though it is uncommon. Other minor punctal plug side effects include the plugs falling out, watery eyes, or partial displacement of the plugs. Rare punctal plug complications include a growth that develops from irritation (Pyogenic granuloma) or narrowing of the duct (Punctal stenosis).
How long do punctal plugs last?
Biocompatible semi-permanent punctal plugs made to dissolve can last a few weeks to several months. Non-dissolvable silicone punctal plugs are designed to last indefinitely, although they can be removed if needed.
How much do punctal plugs cost?
The cost of tear duct plugs can vary. However, some insurances, including Medicare, may cover the cost of punctal plugs if deemed medically necessary.
Sources
Burling-Phillips, Leslie. Considerations for Lacrimal Occlusion in the Moderate Dry Eye Patient. https://www.aao.org/eyenet/article/considerations-lacrimal-occlusion-in-moderate-dry-
https://www.aao.org/eye-health/diseases/punctal-plugs
Best AL, Labetoulle M, Legrand M, M’garrech M, Barreau E, Rousseau A. Punctal and canalicular plugs: Indications, efficacy and safety. J Fr Ophtalmol. 2019 Mar;42(3):e95-e104. doi: 10.1016/j.jfo.2018.12.003. Epub 2019 Jan 26. PMID: 30692031.https://pubmed.ncbi.nlm.nih.gov/30692031
