If you have dry eyes and your symptoms don’t improve with artificial tears, a doctor may recommend punctal plugs. They can help reduce excess tear loss from the ducts in your eyes.
Punctal plugs are small devices inserted into the eyelids. As their name suggests, they can “plug” the puncta (tear ducts) in the eyes, which may help alleviate symptoms of dry eye.
Usually, the puncta in your eyelids are responsible for creating tears to help lubricate your eyes. When you have dry eye your eyes may produce too many tears, or the puncta may not produce tears as well as usual. Both cases can make dry eye symptoms worse.
Learn more about how punctal plugs work, their success, and what you can expect in both the short- and long-term following treatment.
Punctal plugs help reduce excess tear loss from the tear ducts in your eyes. They can also ensure that the tears you do have stay in your eyes for longer.
Excess tearing and moisture loss are common symptoms seen in dry eye, along with redness, itchiness, and burning. The purpose of punctal plug treatment for dry eye is to stop tear loss so that your eyes can stay properly moisturized.
It’s estimated that about
- age, with the risk increasing after
50 years - wearing contact lenses
- excessive screen time
- certain autoimmune diseases, such as lupus
- nutritional deficiencies, such as omega-3 fatty acids or vitamin A
Sometimes punctal plugs may also be used temporarily for certain eye procedures, such as laser-assisted in situ keratomileusis (LASIK) surgery.
There are two types of punctal plugs an eye doctor may consider: dissolving (temporary) and semipermanent punctal plugs. Both are small in size, similar to a grain of rice.
Dissolving punctal plugs
Dissolving punctal plugs may be recommended in cases in which you’re interested in trying this treatment for dry eye but would like to see how well it works. They may also be used as follow-ups to certain eye surgeries.
Dissolving versions are considered temporary because they only last a few days or months at a time. Over time, these plugs dissolve and absorb into the body after their initial placement in your eyelids.
Semipermanent punctal plugs
Semipermanent punctal plugs, on the other hand, offer a more long-term solution. Unlike dissolving plugs, which are often made from collagen, semipermanent versions are created with acrylic or silicone.
Like dissolving types, semipermanent punctal plugs may be inserted in your eyelids. These types of punctal plugs may last for several years but are removable by an ophthalmologist.
Punctal plug insertion is an outpatient procedure, and you can resume your usual activities once your appointment is over.
The steps for insertion are similar for both temporary and semipermanent punctal plugs. After an eye doctor has selected the correct size and type, they’ll numb your eyelid with a topical anesthetic. Then, they’ll insert the plug in your tear duct by hand.
You shouldn’t feel any pain during a punctal plug procedure, but it’s possible to feel light pressure during punctal plug placement.
Punctal plugs are considered a
If you do develop side effects from punctal plugs that are worse than your initial dry eye symptoms, a doctor may advise that you stop using them. While temporary plugs dissolve on their own, semipermanent versions will need to be removed by an eye doctor.
While punctal plugs are generally considered safe, there are still some risks that may occur. It’s important to discuss these with an eye doctor before you have the procedure.
Possible risks in the eye include:
- irritation
- excess tear production
- redness
- swelling (if long-term, may cause tear duct scarring)
- infections (this is rare)
It’s also possible for punctal plugs to get displaced or dislodged, which may occur from initial placement issues or from rubbing your eyes.
A 2020 study also found that spontaneous dislodgement can occur within 90 days of treatment.
While punctal plug loss is common, it’s not considered an emergency. If you suspect this has happened, you may want to speak with a doctor. Don’t attempt to reinsert the plug on your own.
For some people, punctal plugs may provide immediate relief from dry eye symptoms. You may experience immediate relief because the plugs stop excess tear loss directly rather than trying to keep your eyes moisturized with artificial tears as your only dry eye treatment.
Depending on the severity of your symptoms, you may still need to use artificial tears. The difference is that you may not need to use them
Also, relief may not be immediate. You may start to feel better gradually after punctal plug treatment.
Punctal plugs are primarily used to treat dry eye, and they have the potential to reduce your symptoms. They may reduce your reliance on artificial tears, though you may still need these types of eye drops.
While the procedure itself is safe, there may be short-term and long-term risks to consider. If you’re considering punctal plugs, talk with an eye doctor about the risks as well as the potential benefits of these devices.
