Punctal Occlusion

If you've used drops or ointments in the past and haven't gotten relief from your dry eye condition, Dr. Benjamin may want to occlude (block) your puncta.  Puncta are the drainage ducts that your old tears, or extra tears, can escape through while your glands are making new ones.  In each of your eyes, there is one punctum in the top eyelid and another on the bottom eyelid, at the corner of the eye that is towards your nose.  About 80% of the tears drain from the lower, 20% from the upper puncta.

Punctal plugs do exactly what they sound like: they stop the drains, just like the plug in your kitchen sink.  Punctal plugs are made of very soft flexible silicone, similar to that used in contact lenses.

Punctal Plug Procedure

The procedure is quick and painless and can be done within 5 minutes in our office.  A small plug will be placed in the puncta of each eye to stop the puncta from draining away tears and help keep the surface of your eye moist and lubricated. 

Usually temporary collagen plugs are inserted first to make sure you are a good candidate for permanent silicone plugs.  Collagen plugs dissolve on their own, usually within 7-10 days of insertion.  Once these plugs have dissolved and it is determined that tear film has increased, permanent silicone plugs are then inserted.

Some patients will experience tear overflow (epiphora) with punctal plugs.  Collagen plugs will not prove whether silicone plugs will help, but they can help rule out patients who will have overflow or who simply are very unlikely to benefit.