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December 16, 2016

Punctal Plugs for Dry eyes

A punctal plug is a tiny biocompatible medical device that is inserted into the tear duct (puncta) of an eye to block the duct. This slows down the drainage of the tears from the eye increasing the eye’s tear film and surface moisture to relieve dry eyes. Plugs are one of the treatment options used by our Optometrists as part of our dry eye treatment protocols.

There are two types of tear duct plugs:

  1. Semi-permanent, typically made of long-lasting materials such as silicone
  2. Dissolvable, made of materials such as collagen that the body eventually absorbs.  Last from a few days to as long as several months.

Dissolvable punctal plugs are sometimes used to determine if the treatment works for your dry eye condition. If so, then semi-permanent punctal plugs may be considered.The plugs are made of silicone, collagen, hydrophobic acrylic polymer, polydioxanone and hydrogel.

Each eyelid has one punctum, located at the inner margin near the nose. Punctal plugs can be inserted in the puncta of the lower lids, the upper lids or both.  Our Optometrists use a special instrument to measure the size of your puncta to determine the proper size of the punctal plug needed to block the channel and keep it securely in place. An instrument may be used to dilate the tear duct opening for easier insertion. To prepare you for the procedure, our Optometrists may use local anesthetic before inserting the punctal plug however in most cases, no anesthetic is needed.  Other than slight initial discomfort, you should not feel the punctal plug once it is in place. After the procedure, you should be able to resume normal activities.

For the most part, punctal plug insertion is uneventful and rarely involves serious side effects or problems.Some side effects that can occur include excessive tearing or watery eyes if the punctal plug works too well. If this is the case, the plug may need to be removed or replaced with a different type to better control the amount of tears in the eye. Displacement or loss of the plug is common and can occur when people rub their eyes. If this is the case, a replacement plug will need to be re-inserted.  may occur though rare.  In these cases, you may need treatment antibiotics and/or removal of the punctum plug.

As part of our dry eye treatment, Our Optometrists prefer to treat the underlying inflammation prior to using plugs.  If you are suffering from dry eyes, book an appointment with one of the Optometrists at our dry eye clinic.  Alberta Health Care covers visits for dry eyes for all age groups.  Stop suffering and enjoy the previous moments of life.


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