Punctual Plugs

Punctal plugs are another type of device designed to help provide relief from dry eye symptoms. They are small devices which are placed in the tear ducts (puncta) of the eyes, and help prevent fluid from draining from the eyes. This helps keep the surface of the eyes more moist, and to relieve the itching, burning sensations that come with dry eye.

What are Punctal Plugs?

Punctual plugs are tiny devices (about the size of a grain of rice) which are inserted into the tear ducts (puncta) of the eyes, which assist the draining of fluid from the eyes. This keeps the eyes more moist, which helps relieve the painful itching or burning which can come with dry eye.

These plugs are generally inserted in the puncta in the upper or lower eyelids (or both if necessary), and there is a different available plug type which is placed in another part of the tear duct (the canaliculus).

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When are Punctal Plugs Used?

Punctual plugs are used when patients are suffering from dry eye, which is when their eyes are not making enough tears or tears of poor quality, leading to dry, irritated eyes. Often, eyedrops are used to moisten the surface of the eyes and treat dry eye, but for some people having punctal plugs inserted can greatly increase their comfort.

Types of Punctal Plugs

Temporary/ Dissolving Plugs

These punctal plugs are made of a material which naturally breaks down over time and is safely absorbed by the body. (Collagen is often used for these.) This type of plug can remain in the eyes anywhere from a few days to several months, and are often used to help ensure the eyes remain moist following refractive surgery like LASIK (dry eye is very common following surgical procedures). They are also a good option for those interested in trying out punctal plugs to relieve dry eye without a long term commitment.

Semi-Permanent Plugs

Semi-permanent plugs are made out of a longer lasting medical plastic, and are designed to stay in the eye for years. They cannot be seen at all in the eyes, and can be removed by an ophthalmologist if the need arises.

Types of Punctal Plugs
How Are Punctal Plugs Inserted?

How Are Punctal Plugs Inserted?

The first step to getting punctal plugs inserted is for the doctor to examine your eyes to determine which type and size of plugs are best for you.

Then, either your tear ducts may be numbed (your doctor will determine if this is necessary, and the plug is placed into your eyelid. You might feel some pressure as the punctal plug is inserted, but discomfort should be minimal, and you should be able to resume normal activities immediately after the procedure.

How Are Punctal Plugs Inserted?

Possible Risks and Side Effects

As with all procedures and treatments, punctal plugs come with some potential risks and side effects.

The most commonly experienced minor side effect is an irritating or scratchy feeling in the corner of your eyes where the plugs are. In most cases, this feeling eventually goes away, or patients become used to it.

A more problematic side effect is that the plugs make your eyes overly watery with too many tears. If this occurs, the plugs may need to be removed or replaced with a different type.

It is uncommon, but possible for the plugs to move or come out of the eyes (usually as a result of rubbing the eyes.)

Punctal plugs can sometimes cause irritation of the tear ducts, leading to inflammation and swelling. If left untreated, this inflammation can lead to damage to the tear ducts.

If the plugs don’t fit properly, they can stick out of the tear ducts and cause irritation by rubbing against the eye or eyelid.

Eye infections due to punctal plugs can occur, though this is very rare. In such cases, treatment will be required for the infection, and your doctor may decide to remove the plugs.

If you experience any sort of side effect after receiving your punctal plugs, contact your doctor immediately for advice on what to do.

Which Patients Should Not Get Punctal Plugs?

Punctal plugs are not for everyone. Certain conditions can make it inadvisable to get them; your doctor will let you know if this is a case during your consultation.

Patients who have an active infection, issues with the drainage of the lacrimal system, or sensitivity to the material the plugs are made of, should not get punctal plugs. Additionally, if a patient has allergic conjunctivitis, punctal plugs should be avoided as they could result in allergens remaining on the ocular surface. Patients with severe blepharitis should also avoid punctal plugs.

When Are Punctal Plugs Removed, and What is the Process for That?

If certain serious side effects occur, your doctor may opt to remove your punctal plugs.

Most punctal plugs can be removed without surgery, by simply using forceps to pull them from the tear ducts or flushing them out with a saline solution.

Punctal plugs which were inserted deeper (inside the canaliculus) have to be surgically removed.

Types of Punctal Plugs
How Are Punctal Plugs Inserted?

Speak With Our Doctor About Punctal Plugs

If other treatments for dry eye, such as eye drops or artificial tears, haven’t done enough to relieve your symptoms, punctal plugs may be what you need. Contact Amplify EyeCare Manhattan at (212) 752-6930 to schedule a consultation today. Following an examination, our doctor will be able to make a recommendation for you.

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Summary

Learn more about punctal plugs, devices which can be inserted into the tear ducts to help relieve dry eye symptoms.

Testimonials


  • At Amplify with Dr Wernick I was seeking help for seemingly intractable, probably age-related dryness. I've seen other doctors about it, and that has been helpful, but what he explained to me about it and the careful way he answered all my questions gave me so much more of a clear understanding of what is going on (and is not) that I am more able to implement all his and others' recommendations than I was before. And he gave me additional resources for further follow-up. I am most grateful.


    Cynthia Norton

  • Wow! This is a great Eye Care medical facility. I was thoroughly examined by Dr. Pinkhasov for over 2 hours. She made sure to check my eyes for pretty much everything and patiently explained proper care for my eyes. They definitely know how to provide great care and treat their patients right. Now I know why they have such a great reputation and been around for so long.


    Steve Fay

  • Dr. Kavner is a gifted diagnostician and orthoptic therapist. He treated me several decades ago for a condition similar to dyslexia. I was having migraines five times per week. I worked with him for about a year and I experienced tremendous improvement (down to 3-4 per year) that has lasted.


    Mary K.

  • Dr. Kavner recommended two types of eye therapy for my daughter. One of them using bio-feedback. In just three sessions she is seeing considerably better. She shouted this morning: Ooh my God! I could not see these letters with my glasses on, and now I can see them without my glasses. If you are willing and able to invest in improving your vision, this is a good place to go to!


    Peter G.

  • Dr. Kavner recommended two types of eye therapy for my daughter. One of them using bio-feedback. In just three sessions she is seeing considerably better. She shouted this morning: Ooh my God! I could not see these letters with my glasses on, and now I can see them without my glasses. If you are willing and able to invest in improving your vision, this is a good place to go to!


    Kinkie F.

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