I Spy Dry Eyes - Part 2: Punctal Plugs
Artificial tears are effective in treating dry eyes when the cause is due to the tear film layer of our eyes’ surface is evaporating too quickly.
If there’s more at play in our Dry Eye condition, then we’ll need to take a look at the eyes’ anatomy next.
One of the prime anatomical features to examine is a pair of small openings in the inner margin of our upper and lower eyelids - Puncta. Similar to a sink drain, puncta are responsible for draining tears from our eyes back into our system.
Dry eyes can also be caused by either our tears draining too quickly or our eyes not producing enough tears.
When our puncta are anatomically large, it leads to our tears flushing out from more excessively than normal, allowing less maintenance tears from remaining in the eyes to retain moisture. Equally, if we’re not producing enough tears, then our baseline quantity for proper lubrication is inherently lower than what we need for sustenance.
The solution to preventing our surface tears from draining too quickly and retaining what we have is to insert small medical devices, called Punctal Plugs, into the lower punctum of each eyelid to seal the drainage system. This will enable the ocular surface to conserve its natural tears while also maintaining artificial tears in the eyes for a longer period of time, altogether, keeping the eyes sufficiently lubricated.
How, you ask?
It’s very simple. We first instill a mild numbing drop to the region around the punctum. Then, we use an applicator similar to forceps to insert the plug. It may feel a little peculiar, but no pain is observed. The start-to-finish experience lasts about a few minutes.
The collagen plug is placed completely inside the tear duct and dissolves overtime, lasting for a few months. The silicone plug is barely visible as it rests on top of the punctum and can be used as a long-term treatment modality. After assessing your dry eye status, we’ll determine the style of plug most appropriate for you.
What to expect after the insertion?
At most, you may feel a slight scratchy feeling in the inner corner of your eye. This sensation usually resolves on its own by the next day.
Allergy to the plug’s material is rare. Let us know if you are aware of any allergies to collage, silicone, or acrylic substances.
Occasionally, the plugs work too well, causing watery eyes. When you come in for your follow-up appointment after a few weeks, let us know if this is happening to you so that we can make necessary adjustments to our Dry Eye treatment routine.
Long story short…
If you have moderate dry eyes and have tried the artificial tears route with little success, then it might be time to consider the next step of care. Punctal plugs are a simple, low-risk way to relieve Dry Eye disease. With their dual function of plugging the drain and retaining tears, they might just be the missing piece in relieving your symptoms and improving your quality of life. Ready to start your dry eye journey yet? We’re here when you are!