Punctal Plugs

punctal plugs

What are Punctal Plugs

Punctal plugs are small medical devices that can be used in dry eye patients to keep the natural tears on the surface of the eyes longer, and increase the volume of tears on the eyes. Punctal plugs are placed in the ducts (called puncta) located on the inner corners of the eyelids, where the tears drain from the surface of the eye. They can be inserted in the puncta of the upper eyelid, lower eyelid, or both. For the right patient, punctal plugs are a great treatment option for dry eye, especially for people where artificial tears have not worked.

How do Punctal Plugs Work

Punctal plugs work by increasing the eyes tear film, and allowing the natural tears to stay in the eye longer. They increase surface moisture and may help alleviate symptoms of dry eye for many patients.

Types of Punctal Plugs

There are 2 main types of punctal plugs semi-permanent and dissolvable.

  • Semi-permanent- typically made from silicon, can last for years.

  • Dissolvable- made of collagen or other materials that dissolve over weeks to months.

How are Punctal Plugs Inserted

Punctal plugs are an in office procedure for the treatment of dry eye, performed under informed consent of the patient. You may feel some slight pressure as the plug is placed in the eyelid. There is generally little to no discomfort during or after the procedure, and patients can resume their normal activities after the procedure.

  • Determine size and type of plug to use

  • Anesthetize the eyes

  • Dilate punctum for easier insertion

  • Insert plug into punctum of lower (and/or upper) lids using forceps or pre-loaded inserter

  • Ensure proper placement of plug

Side Effects and Complications of Punctal Plugs

It is uncommon to experience any adverse reactions with insertion of punctal plugs. In most cases of adverse reactions punctal plugs can be easily removed. Most adverse reactions occur with the use of semi-permanent plugs, which is why at Envision Specialty EyeCare and Dry Eye Center we generally use dissolvable plugs.

Adverse reactions could include;

  • Excessive tearing

  • Foreign body sensation

  • Enlarging of puncta

  • Infection

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