EYE CARE ASSOCIATES OF NEVADA | 2285 Green Vista Drive Sparks, NV

Dry Eye Treatment Q&A: Punctal Plugs


There are multiple different symptoms for dry eye – stinging, burning, foreign body sensation, excessive tearing, redness, etc. One of the tools we use to help treat this chronic condition is through punctual plugs. This blog will highlight the use of punctal plugs – one of the various dry eye treatments we offer at Eye Care Associates of Nevada.


What are punctal plugs and how do they work?

Punctal plugs are biocompatible implants that are used to occlude the tear ducts of your eye. There are two tear ducts (upper and lower) that help drain the tears of your eye. Our tears naturally drain through the ducts to the nose before descending to the back of the throat. Patients with dry eye may have inadequate tears or excessive drainage from these ducts and may benefit from having punctual plugs. The intent behind occluding this pathway is to increase the amount of tears that rest on the surface of your eyes – thus, improving the stability of tear film and improving the health and comfort of your eyes. There is also research that demonstrates that punctual plugs may also increase the efficacy of other dry eye treatments by increasing tear volume and increasing contact time of eye drops.


Are punctal plugs permanent?

There are three main categories of punctal plugs: temporary, semi-permanent and permanent. The plugs are composed of collagen, silicone, or other polymers that are safe for the body. In many cases, we like to trial temporary plugs that dissolve within weeks to months to see if the patient benefits from their dry eye symptoms before considering a more permanent option. It is important to understand that permanent punctal plugs are reversible and may be removed at any time if there are any complications. Permanent plugs may fall out over time – your eye care physician checks for their placement at your regular dry eye follow-up exams.


What does the procedure consist of?

After the consultation to determine eligibility for punctal plugs, the insertion procedure is often scheduled at a following visit. The procedure takes less than 15 minutes. It requires finding the right size punctal plug for your tear ducts, a topical numbing drop for comfort, and the application of the plug itself. A temporary plug will not be seen externally while a permanent plug will have the flattened head of the plug resting on top of the tear duct, which may be visible with a microscope. Patients may initially have awareness of the plug, but often become accustomed to it with time.


What are some risks and benefits I should understand for punctal plugs?

There are many factors to consider before deciding to treat with punctal plugs. These include pre-existing ocular surface inflammation, systemic health issues, history of prior eye infections, allergies, etc. Please schedule an appointment with us today to see if you may benefit from this dry eye treatment.