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My Eye Doctor Said I Need Punctal Plugs. What Are Punctal Plugs?


Punctal Plugs Punctal Plugs for Dry Eye Tear Duct Plugs Punctal Plug Types Tear Drainage Blockage Treatment Dry Eye Treatment Options Temporary Punctal Plugs Permanent Punctal Plugs

WHAT ARE PUNCTAL PLUGS AND HOW ARE THEY USED FOR DRY EYES?

PUNCTAL PLUGS are tiny little devices inserted into the tear ducts to block tear from draining. The idea is that they trap tears in the eye rather than letting them drain and evaporate through the nose. I think punctal plugs can be a good and also bad option for many of my patients. Here we will discuss what they are. Click here for my other blog posts on PUNCTAL PLUGS.

 

 

First Let's Chat Tear Flow

The flow of tears is fascinating. Tears are made in LACRIMAL GLAND constantly. Upon a blink, the eyelids help flush tears over the ocular surface. The tears do their job: lubricate the ocular surface, wet a contact lens, flush out debris .  .  . and all in one motion of the blink. It's frankly quite amazing. The end of the cycle is when the tears exit the eyes to evaporate through the nasal cavity. In this illustration, see the PUNCTUM? Four tiny holes in the corners of the eyelids drain tears upon each blink. Two on the top. Two on the bottom. 

 

 

 

Punctal Plugs Punctal Plugs for Dry Eye Tear Duct Plugs Punctal Plug Types Tear Drainage Blockage Treatment Dry Eye Treatment Options Temporary Punctal Plugs Permanent Punctal Plugs

Where Do Punctal Plugs Go?

This is a very case-by-case thing. IN general, I like to place PUNCTAL PLUGS on all 4 openings to the PUNCTA (plural for punctum). There are many scenarios: both bottom, both top, or perhaps top and bottom for just one eye. Your eye doctor will have to make this decision. 


 


Are Punctal Plugs Safe?

PUNCTAL PLUGS have been around for a very long time. A lot of advancements in materials and insertion methods since the 1980s has made PUNCTAL PLUGS more comfortable and an effective treatment option for DRY EYE SYNDROME.

 

What Are The Types of Punctal Plugs?

I like to make a super simplify here. There are 2 types I use: temporary and permanent. My preference is definitely the TEMPORARY PUNCTAL PLUGS due to ease of insertion and for me, lowered risk for long term infection of the PUNCTUM.  Some optometrist use the temporary ones to determine if their patient is a good candidate for the permanent ones. This is also a great way to evaluate a patient for EPIPHORA - that's when the there's too many tears and excessive tearing happens. 


 

Punctal Plugs Punctal Plugs for Dry Eye Tear Duct Plugs Punctal Plug Types Tear Drainage Blockage Treatment Dry Eye Treatment Options Temporary Punctal Plugs Permanent Punctal PlugsPermanent Punctal Plugs

These are usually made out of silicone, Ironically, the name is kinda misleading because even the PERMANENT PUNCTAL PLUGS can be removed if needed. Your eye doctor needs to do this! They are designed to last forever, so it is technically a one-and-done procedure when inserted. They can be fully inserted deep inside the PUNCTUM or they can be partially inserted where the head of the PERMANENT PUNCTAL PLUG sits on the eyelid. The shape of these look like a little arrow. There are pros and cons to each style. Here are my biggest pros and cons.

 

FULL PUNCTUM STYLE

  • PRO: Completely invisible, no foreign body sensation on the eyelid

  • CON: More difficult to remove if needed

 

 

 

PARTIAL PUNCTUM STYLE

  • PRO: Easy to remove if needed

  • CON: Sits on the eyelid, sometimes persistent foresight body sensation on the eyelid

 

 

Temporary Punctal Plugs


Temporary. I like this type. These are usually made out of various polymers of plastic and collagen. They slowly dissolve, so there's little risk for infection. I also like the flexibility so I can really personalize the time period depending on the patient case: 5 days, 2 weeks, 1 month, 3 months, 180 days. Doing the 180 days 2X a year is a good option for many of my DRY EYE SYNDROME patients. The shape of these is a cylindrical rod.


 

PROS & CONS

  • PRO: Very low risk of infection

  • CON: Needs to be repeated

 

 

COULD BE A GOOD THING


PUNCTAL PLUGS keep tears on the ocular surface longer - helping my DRY EYE SYNDROME patients feel better. Picking the type of PUNCTAL PLUG will take a conversation with your eye care provider. I can't make that decision for you, but hope this blog post helped you understand the options better.

 

 

 

Hi, I’m Dr. Tanya Gill, optometrist and founder of We Love Eyes. I started We Love Eyes in 2014 while trying to help one of my (stubborn) patients with contact lens discomfort. In 2016, I had 3 products. Fast forward to today - We Love Eyes has almost 30 SKUs. It’s been an amazing journey. Explore my life’s work at weloveeyes.com. Check out my content on TIKTOK. See the profile page and see the playlist DRY EYES . xo

 

 

 

 

 

 

 

  • Punctal Plugs

  • Punctal Plugs for Dry Eye

  • Tear Duct Plugs

  • Punctal Plug Types

  • Tear Drainage Blockage Treatment

  • Dry Eye Treatment Options

  • Temporary Punctal Plugs

  • Permanent Punctal Plugs

  • What are punctal plugs

  • How do punctal plugs work

  • Are punctal plugs safe

  • Where do punctal plugs go

  • Tear duct plug pros and cons

  • Tear retention treatment for dry eyes

  • Collagen plugs for dry eyes

  • Silicone punctal plugs side effects

  • Plugged tear duct treatment in adults

  • Eye doctor punctal plug recommendations

 

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