WHEN TO USE PUNCTAL PLUGS: Is It a GOOD or BAD Idea? Are You Trapping Unhealthy Tears?
ARE PUNCTAL PLUGS A GOOD IDEA?
PUNCTAL PLUGS are tiny medical devices placed inside those tiny openings in the corners of the eyelids. They prevent tears from draining out and keep tears inside the eye longer. This can be highly beneficial for patients with DRY EYE SYNDROME. They can alleviate dry spots on the cornea, improve contact lens comfort, reduce redness, and reduce that burning feeling. Here we will discuss MY thoughts on PUNCTAL PLUGS. When I use them. When I don't. Click here for my other blog posts on PUNCTAL PLUGS.
ARE PUNCTAL PLUGS A BAD IDEA?
PUNCTAL PLUGS can also be a bad idea. Most of my patients with DRY EYE SYNDROME have tears that are unhealthy. Let me explain. DRY EYE SYNDROME is an inflammatory condition. In the case of AQUEOUS DEFICIENT DRY EYE SYNDROME, the lacrimal gland is making unhealthy tears and/or not enough healthy tears. Trapping these unhealthy tears on the ocular surface just makes the ocular surface and surrounding eyelids feel and look worse. In the case of EVAPORATIVE DRY EYE SYNDROME, the meibomian glands are not releasing healthy oil and/or enough oil into the tears. Trapping this unhealthy mix can also make the ocular surface and eye area look and feel worse.
How Do I Know Your Tears Are Unhealthy?
Some Dry Eye Specialist Optometrists use a device to measure the amount of inflammation in the tears. They are testing for osmolarity. From my clinical experience, I judge unhealthy tears by signs and symptoms. The eyes seldom lie. The list is long, but here is my common short list I ask myself:
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- What is the Tear Break Up Time score?
- Is the patient feeling better or worse?
- Is the patient looking better or worse?
- Are there dry spots on the cornea?
- Can my patient wear eye makeup?
- Can my patient wear contact lenses?
What I'm looking for is a change (better or worse) in these questions. This should also tell you that I NEVER prescribe PUNCTAL PLUGS on the first visit! I'm looking for change in the positive direction. I only will insert PUNCTAL PLUGS once the tears are healthy.
How Do I Get Healthier Tears?
Before PUNCTAL PLUGS for DRY EYE SYNDROME, getting a proper diagnosis is vital. Here I recommend seeing a Dry Eye Specialist Optometrist, not just a regular glasses / contact lens optometrist. They have devices, tools, and the clinical expertise to diagnose and offer you a personalized eye care routine to get those tears healthier. PUNCTAL PLUGS are not a quick fix. I think they are a quick disaster if done too early. Here's a list of items a Dry Eye Specialist Optometrist can provide:
DIAGNOSIS: Do you have AQUEOUS DEFICIENT or EVAPORATIVE type of dry eyes?
EYE CARE ROUTINE: Daily eyelid hygiene to address the eyelids and eye glands.
PRESCRIPTION EYE DROPS: Restasis, Xiidra, Xdemvy, Lotemax, Azasite, Tobradex to name a few.
TEMPORARY OR PERMANENT: A discussion with your Dry Eye Specialist Optometrist will also help figure out what type of PUNCTAL PLUGS is ideal for you. Read more the types here.
TIMING: A good clinician will know the timing of things and when the appropriate time to insert PUNCTAL PLUGS. Could be visit #2. Could be visit #NEVER.
TRAP HEALTHY TEARS
PUNCTAL PLUGS keep tears on the ocular surface longer - helping my DRY EYE SYNDROME patients feel better. They work their best when your tears and healthy AND trapped into the eye care. Do yourself the biggest love ever. FIND a Dry Eye Specialist Optometrist to offer guidance with your DRY EYE journey. DRY EYE is no fun, but a good clinician will make the journey less bumpy.
- Read my blog posts on PUNCTAL PLUGS
- Find a Dry Eye Specialist Optometrist here
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Punctal Plugs
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Are punctal plugs good for dry eyes
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Punctal plugs pros and cons
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Punctal plugs side effects
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When to use punctal plugs
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Do punctal plugs really work
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Types of punctal plugs
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Tear retention devices
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Punctal occlusion for dry eyes
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Dry eye treatments that work
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Alternatives to punctal plugs
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Aqueous deficient dry eye
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Evaporative dry eye treatment
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Healthy tears and inflammation
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Restasis vs punctal plugs
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Xiidra for dry eyes
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Tear breakup time test
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Contact lens discomfort and dry eyes
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Best optometrist for dry eyes
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“Should I get punctal plugs for dry eyes?”
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“Why your dry eyes might get worse with punctal plugs”
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“Is it safe to use punctal plugs if I wear makeup?”
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“Best timing for punctal plug insertion”
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“How to tell if your tears are unhealthy”
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What are the risks of punctal plugs?
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Are punctal plugs permanent?
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Can punctal plugs make dry eyes worse?
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Who should not get punctal plugs?
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How do I find a dry eye specialist?