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Writer's pictureDr. Ryan Corte

Punctal Plugs for Dry Eyes: What You Need To Know

Do you suffer from dry eyes and have been recommended punctal plugs as a treatment? If so, you might be curious about how they work and whether they are safe.


In this article, we’ll cover everything you need to know about punctal plugs for dry eye disease.

Punctal plugs for dry eye disease can be very impactful for patients that have moderate to server dry eye symptoms.

What is dry eye disease?

Dry eye disease affects the front of the eye, also known as the ocular surface.


Several factors can contribute to or worsen dry eyes, including environmental conditions, age, hormonal changes, medications, contact lens wear, systemic conditions, and eye surgeries.


Common symptoms include irritation, itching, burning, excessive tearing, and blurred vision.


One effective treatment option for dry eye disease is the use of punctal plugs.


How do punctal plugs work?

Punctal plugs help reduce the drainage of tears from the surface of the eye.


In cases of dry eyes, a process called "reflex tearing" can occur, where the eye signals the brain to produce an excess of tears, often causing them to spill down your face. While this might seem beneficial, these tears are typically not of the right composition and can actually worsen dry eye symptoms.


Punctal plugs are tiny devices, about the size of a grain of rice, designed to block tear drainage by fitting into the tear ducts. They can be placed in both the upper and lower tear ducts and come in various sizes and types, which your eye doctor will select based on your needs.


Types of punctal plugs

Your doctor will determine the best type of punctal plug for your eyes. Here are the main options available.


  • Collagen plugs – These are temporary punctal plugs that last between 2 weeks and 3 months, typically dissolving on their own.

  • Silicone plugs– These are permanent punctal plugs that do not dissolve and remain in place for long-term use.

  • Intra-canalicular plugs – These permanent plugs are inserted deeper into the tear duct and are invisible to the naked eye.


How are punctal plugs inserted?

Punctal plugs are inserted by your doctor during an in-office procedure.


Because the tear duct is very small, it is viewed under a microscope for magnification. To ensure comfort, anesthetic eye drops are applied before the procedure.


Using forceps (tweezers), the doctor inserts the punctal plugs, a process that typically takes less than a minute and is painless.


How are punctal plugs removed?

If punctal plugs need to be removed, your eye doctor can do this in-office.


They may be flushed out with saline solution or gently removed with forceps, both of which are painless procedures.


Are there any risks?

Yes, though rare, infections can develop a few days after punctal plug placement.


Symptoms may include redness, irritation, and discharge, particularly in the corner of the eye. Your eye doctor will typically treat the infection with eye drops and may remove the plugs if needed.


Occasionally, punctal plugs may fall out if they are too small. In this case, your doctor will simply refit you with a larger size.


Final thoughts on punctal plugs for dry eye disease

Punctal plugs are a common adjunct therapy for dry eye treatment that eye care professionals regularly use. At Northlake Eye, we frequently fit silicone plugs as part of our treatment approach!


Interested in learning if you're a candidate for punctal plugs?

Schedule an eye exam with one of our doctors of optometry today!

Give us a call or simply schedule online: Northlake Mall | Concord Mills | Biltmore Park | Asheville Mall

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