Dry eye treatment can include over-the-counter eye drops, prescription medications, ointments, and more. In moderate to severe cases of dry eye disease, these treatment options may not be enough to completely relieve symptoms of burning, grittiness, and irritation. For those resistant cases, punctal plugs may be the answer. Punctal plugs are small medical devices that can provide a more permanent form of treatment and deliver long term relief for those who are significantly affected by dry eye disease.
What Are Punctal Plugs?
On the inner corner of the eyelid, there is a very tiny hole, called the punctum. The punctum is where tears are drained after being spread across the front surface of the eye. Punctal plugs are very small biocompatible implants that are inserted into the punctum by an eye care professional. By blocking the punctum, these devices can help relieve symptoms of dry eye disease by reducing tear drainage and allowing the eye’s natural tear film to remain on the front of the eye longer. This improves the lubrication of the cornea, and helps prevent symptoms such as irritation and burning from arising.
There are several different types of punctal plugs. Temporary punctal plugs, made of collagen that can dissolve after being inserted, will last anywhere from a few weeks to months at a time. Once these plugs have completely dissolved, they will lose their effectiveness. For a more permanent option, there are punctal plugs made of a silicone material that can last for years or longer. If you are considering punctal plugs, your doctor may choose to initially try a temporary plug and seeing how effective it is for you, before moving to a more permanent option.
What to Expect with Punctal Plugs
The process of inserting punctal plugs is painless and simple. It is done in the office by your eye doctor, and it can be completed in a matter of minutes. First, your doctor may measure the size of your punctum to determine the appropriate sized plug to be inserted. Then, using forceps and a lighted microscope, your doctor will carefully place the device into the punctum, then repeat the process with the other eye. Sometimes the doctor will place a numbing drop in the eye prior to insertion, though it is not absolutely necessary. The process of insertion does not cause any pain or discomfort – in fact, most people cannot feel it at all. There are very few risks or side effects associated with the insertion of punctal plugs. The most common side effect could be an allergic response or hypersensitivity reaction to the plug, in which case the doctor can immediately and safely remove it.
Once the plug is inserted, it cannot be felt at all, and creates no irritation or awareness. Improvement in dryness and irritation can begin to occur within the first day or two. Your doctor will likely ask to see you back for a follow-up within a few weeks following insertion so they can monitor your symptoms and ensure that the device is properly treating your dry eye disease.