Punctal plugs are small devices that block the tear duct to prevent fluid from draining from the eye, used to treat dry eye. They can be temporary or permanent and have a risk of being lost or causing inconvenience.
Punctal plugs are small devices that fit into the tear duct of the eye. The plug is designed to block the duct and prevent fluid from draining from the eye into the nose. Puctal plugs are used to treat an eye disorder called dry eye when other treatments don’t work.
Dry eye is a disorder with several causes, including environmental effects, reduced tear production by the lacrimal glands, and low-quality tear production. Tears are made up of several substances, including oils and mucus, that form a film over the eye and keep it moist. If your tears lack mucus or oils, the liquid may be too watery to protect your eye adequately. This causes symptoms such as pain and itchiness in the eyes, sensitivity to wind, light and smoke, and visual disturbances. In such cases punctual plugs can be applied to slow down the drainage of liquids.
There are several types of punctal plugs. The standard punctal plug is fitted to the top of the tear duct, or puncta. For the patient, these provide an advantage as they can be removed and replaced easily. The associated disadvantage is that even incorrectly fitted plugs can be lost more easily. Another type of punctal plug, called an intracanalicular plug, is inserted inside the canaliculi, which is the tear duct itself. These are not easily removed or lost, but cannot be replaced at home.
Punctal plugs can be temporary or permanent. When they are temporary, they are made from collagen and are tailored to determine if a particular patient will benefit from the plugs. If the plugs help prevent dry eye, the patient is then fitted with a set of plugs made of silicone or other synthetic material. These caps will last for several months and are suitable for people who experience seasonal dry eye as well as people with a lifelong version of the condition.
Plugs labeled “permanent” aren’t always. Permanent plugs can last a year or more, but all plug users have about a 40 percent risk of losing a plug within the first six months of use. This is because the plugs that are inserted into the puncta can extrude spontaneously, an effect that tends to occur within the first three months of use. Another possible risk is that of inconvenience to the plug site, which occurs in about 10% of cases. In these cases, it may be necessary to remove and refit the plugs to ensure they are the correct size and shape for the patient.
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