For those suffering from persistent symptoms of dry eye disease, punctal plugs may be a viable option. These small biomedical devices are placed in the tear duct by an optometrist, and work to keep the eye lubricated and comfortable. Punctal plugs can be an effective treatment for dry eyes, especially in cases where multiple previous treatment approaches, like artificial tears, ointments, or even prescription medications, have not provided relief. If the burning, irritation, redness, and watering associated with your dry eye disease has not improved after diligent treatment attempts, punctal plugs may be an option for you.
How do Punctal Plugs for Dry Eye Disease Work?
Punctal plugs are tiny devices made of biocompatible material that is inserted painlessly into the tear duct near the inner corner of the eye. Once inserted, the punctal plug blocks the drainage of tears. With outflow of tears blocked, the tears will stay on the front of the eye longer, keeping the cornea lubricated and well nourished. The plugs allow both natural and artificial tears to work longer and provide extended relief of dry eye symptoms.
There are several different types of punctal plugs to make the treatment more individualized. Dissolvable punctal plugs are a temporary choice made of collagen that slowly dissolve in a few weeks or months. They may be initially selected by doctors as a “test run” to make sure punctal plugs are an effective treatment and the body doesn’t react poorly. If temporary plugs are successful in treating dry eye symptoms, the next option may be a permanent punctal plug, which is typically made of silicone or acrylic. These types of plugs can last for years at a time, but may still be removed by the doctor if an adverse reaction occurs.
What to Expect from Your Visit
The process of inserting punctal plugs is quick and pain free. The doctor may need to measure the puncta, or the small opening on the inner lower eyelid margin, to help choose the appropriate type and size of implant. In order to insert the punctal plug, the optometrist will only need to use a light, a microscope, and a small pair of surgical tweezers to gently insert the implant into the puncta. Most of the time, no anesthetic or other eye drop is necessary, and the in-office procedure is completed in a matter of seconds. Once the punctal plug has been successfully inserted, there is no discomfort and the implant should not cause any irritation. Complications involving punctal plug insertion is rare, though some people may have adverse reactions to the material of the implant. In these cases, the implant can be easily removed.
Following a successful insertion, you can immediately go about your daily life. Side effects are rare, though occasionally excessively watery eyes can occur, and rarely the puncta can get infected. Your optometrist may ask you to return for a follow-up appointment a few weeks or months after the insertion to verify that the plug is doing its job and effectively keeping the corneal surface lubricated. At your annual comprehensive exams, your doctor will ensure that the plug is still in place and no treatment modifications need to be made.