What are punctal plugs?
Punctal plugs are small plugs that are inserted into the lacrimal points to prevent tear drainage. This enables the tear film to be preserved for a longer time on the surface of the eye to relieve the symptoms of ocular dryness and prevent damage that can occur in the cornea.
They are almost invisible to the eye and are usually made of silicone, although, in some cases, temporary plugs made of collagen, a natural substance that dissolves and is absorbed by the body after a few weeks, can also be used.
In which cases are they used?
They are indicated for dry eye patients who have severely reduced tear production. This occurs, above all, in postmenopausal women or elderly people. The most serious cases are associated with Sjögren’s syndrome, an autoimmune disease that affects the external secretion glands (exocrine) of the body, especially the lacrimal and salivary glands.
In addition to performing a complete optometric and ophthalmic assessment, the specialist may require additional tests for the diagnosis of dry eye, such as Schirmer’s test, which measures tear quantity by means of paper strips that are placed on the external lateral part of the eye and determines whether there is a deficiency in production.
The procedure is performed in the consulting room under topical anaesthesia (drops) and is completely painless for the patient. The punctal plugs can be placed in the tear ducts of the lower and/or upper eyelids, which collect the tears produced by the lacrimal glands found in the corner of the eyelid edge touching the nose.
The plugs are placed by the specialist with the help of a clip and, once placed, adapt to the shape and size of the lacrimal point of each eye, without usually producing any discomfort.
Punctal plugs are a safe and effective method, and reversible, as they can be easily removed in the consulting room, if necessary.
It may happen that, for various reasons (for example, rubbing the eyes), the tear plug moves or is lost, even without the patient noticing, so it is important for the ophthalmologist to regularly monitor proper functioning.
There are very few risks associated with this treatment, and it is uncommon for complications, such as excessive tearing (watery eyes), infections or allergies, to occur.
In spite of improving the hydration of the eye, it may still be necessary to use artificial tears, which before inserting the punctal plugs were insufficient to keep the ocular dryness under control.