A punctal plug is a very tiny, bio-compatible device that is inserted into the tear ducts to block drainage. Once inserted into the tear ducts, punctal plugs increase the eye’s tear film and surface moisture to relieve dry eyes.
No larger than a grain of rice, punctal plugs are also known as; punctum plugs, occluders, and lacrimal plugs.
There are two types of punctal plugs: semi-permanent and dissolvable. Semi-permanent punctal plugs are typically made of long-lasting materials such as silicone; whereas dissolvable plugs are made of materials that eventually absorb such as collagen, and usually last from a few days to several months. Dissolvable plugs are typically used to prevent dry eyes following LASIK surgery or are used to determine whether a patient can benefit from plugging.
Intracanalicular plugs are another class of punctal plug that are inserted into the canaliculi and typically cannot be seen after insertion. Removal requires them to be flushed out with irrigation.
Punctal plugs come in different shapes and sizes and serve various purposes:
- Slanted or low profile cap – helps to maintain comfort while providing extra stability
- Tapered – uses extra force horizontally to help keep the punctal plug in its proper place
- Umbrella – can be easily seen for easy removal
- Hollow – hollowed interior helps the punctal plug adhere to the shape of the tear duct
- Reservoir – captures and holds tears which help reduce foreign body sensation for increased comfort
- Smartplugs – change shape when warmed up to body temperature and adjust to fill the cavity
- Oasis FormFit plugs – hydrate after insertional and expand to fill the cavity
- FCI “Perforated” plug and Eagle “Flow Controller” plug – for people who experience overflow if fully occluded
In many cases, no anesthesia is used to insert punctal plugs. However, some doctors, may choose to use local anesthesia.
Your eye doctor will measure the size of your tear duct openings to determine the proper size of the punctal plug needed to keep it in place and block drainage within the channel – sometimes only a lighted, close-up examination is needed to determine the size and type of plug you need.
Inserters that resemble forceps, syringe-style inserters, actual forceps, or other instruments may be used by your doctor to place the punctal plug into your eye’s tear duct.
Initially, there may be slight discomfort. However, once your punctual plug is inserted and in place, you should not feel it, and should be able to drive yourself home and resume normal activities.
If you are a victim of dry eyes and believe you may be a good candidate for punctal plugs, speak to your eye doctor or make an appointment with one of our experienced ophthalmologist today.