Punctal plugs are a simple, effective treatment to combat the irritating symptoms of dry eye.
With symptoms like sore eyes, blurry vision and dryness, Dry Eye can be both painful and frustrating to live with everyday. Luckily, there’s a variety of treatment options available, for all different needs and lifestyles.
At OCULA, we offer an effective solution for dry eye that is a quick and painless procedure, so you don’t have to suffer with those irritating and frustrating symptoms. Punctal plugs are a common and non-invasive therapy treatment used to help stop the effects of dry eye.
What are punctal plugs?
Punctal plugs are small devices (think of the size of a grain of rice) that are inserted into the tear duct which causes block drainage (see image). This enables the tear duct to become firmer, and increases surface moisture to relieve dry eye symptoms. Although there are other options available to combat dry eye, punctal plugs are one of the most effective treatments and require less maintenance than eye drops.
There are two different types of punctal plugs:
Dissolvable: made from materials like collagen, which the body will absorb over time. This type of plug can last between 3 days, up to six months.
Semi-permanent: typically made of long-lasting materials like silicone and are removable. This type of punctal plug is used for more severe symptoms of dry eye. These types of plugs will last up to 12 months.
Temporary or dissolvable punctal plugs can be used to determine if the treatment works for your dry eye condition. If they do, then semi-permanent punctal plugs might be recommended by your optometrist.
Inserting punctal plugs
While inserting punctal plugs may seem a bit daunting, it is a pretty straightforward procedure. If your optometrist recommends punctal plugs, they will assess which size you need. They will then numb your tear duct by using a local anaesthetic eye drop in each eye. This will help you to stop blinking as much during the procedure and minimise any irritation. The anaesthetic means you won’t feel any pain, but you will be able to feel the plug inserted.
Sometimes your puncta may need to be opened a bit wider before the plugs are inserted. As in many types of dry eye, it can become narrow or swollen. If so, a thin, smooth ended rod is placed in the opening and genty twirled. It may feel a little strange, but is painless. This is called ‘dilating’.
As we mentioned, inserting the plugs is simple, and normally only takes a few minutes. The plugs might be handled with sterile forceps or tweezers. Once inserted, the majority of people never feel their plugs at all.
Side effects of punctal plugs
The most common side effect is a slight awareness/ irritation in the corner of your eye, after having them inserted. This wears off as the eyes become used to their presence and is unlikely to occur with temporary (or dissolvable) plugs.
Sometimes the plugs can be too effective and tears can overflow from the eyelid, giving you watery eyes. Occasionally the plug doesn’t sit properly - if it sticks out a bit too much for example, it will feel scratchy and irritating, especially when you blink. In both instances, we’d recommend you come in to remove the plugs.
An almost unheard of side effect is when the plug causes inflammation of the tear duct and areas surrounding it. It could be due to an infection, an allergic reaction to the plugs or perhaps a mechanical irritation. In the case of any prolonged inflammation or discomfort, we’d recommend making an appointment with your optometrist to assess and then remove the plugs.
Is there a cure for dry eye? Unfortunately, dry eye tends to be a condition that needs ongoing management, however treatments such as punctal plug result in effective relief of symptoms.
How long do punctal plugs last? Depending on both the type of punctal plug and the severity of dry eye, punctal plugs can last from days to years.
Do they work? Yes, recent studies of those with dry eye syndrome have had an overall success rate of 76%.
What type of punctal plug is suited for me? Temporary or dissolvable punctal plugs can be used to determine if the treatment works for your dry eye condition. If they do, then semi-permanent punctal plugs might be recommended by your optometrist.
Do I need to use eye drops as well as having punctal plugs? No, the punctal plugs will be able to block the tear duct and prevent the tears from falling, therefore you won't need eye drops as well.
Are punctal plugs painful? You should not feel much discomfort once the punctal plugs are inserted.
If you are interested in punctal plugs for dry eye treatment, book an appointment with one of our specialist optometrists here.