Punctal plugs can be an effective treatment for dry eye.  Punctal plugs are tiny devices, or plugs, which are inserted into the tear ducts located in your eyelids.   As drainage away from the eye is reduced or blocked, you have more tears to keep your eye lubricated and hydrated.

Punctal plugs are often considered when artificial tears (i.e. over the counter eye drops) are not effective or intolerable.

Both oculoplastic surgeons,  Dr. Paul Gavaris and Dr. Lauren Gavaris,  treat dry eye and will determine if punctal plugs are appropriate for you.  Not all patients with dry eye will benefit from punctal plugs.  Your success will depend upon your exact cause.

Treatment for Dry Eye

Most patients have mild dry eye and do well with the use of artificial tears or lubricants.  Changing behavior may also be helpful; avoiding windy, smoky dry conditions or increasing the use of artificial tears when reading or using the computer (we tend to blink less often when concentrating).

Restasis and Xiidra are topical prescription drops used to improve dry eye by reducing ocular inflammation.  Restasis has been in use for over 10 years.  It is used twice a day and is a very popular therapy for patients who require more advanced therapy than artificial tears.

Xiidra was just FDA-approved.  Like Restasis, it reduces inflammation causing dry eye.  It is also used twice a day.  Xiidra gives us another option as not all patients respond to every treatment.

LipiFlow is a new treatment which improves meibomian gland function (MGD).  Treatments are available in our office and is indicated for patients with meibomian gland dysfunction.  The meibomian glands normally produce an oily layer of the tear film which reduces evaporation.  MGD is a common cause of dry eye.

Punctal plugs are a great option for many of our patients.  Chronic use of drops is often impractical to maintain, not to mention the expense.  Punctal plugs are comfortable, easy to insert and can be reversed or removed.

Types of Punctal Plugs

There are two types of punctal plugs, either semi-permanent or dissolvable.  Semi-permanent plugs are made of a biocompatible material such as silicone.  Semi-permanent often last months or longer and can be replaced if they become dislodged.

Dissolvable plugs are made of dissolvable material such as a protein collagen.  This is also biocompatible and lasts a short time.  Often the dissolvable plugs can be used as a “test” to determine if the longer lasting type will be therapeutic.

There are no “permanent” plugs, although the tear ducts can be closed permanently with a minor procedure.

Plugs Inserted in the Office

Plugs are easily and painlessly inserted in the office.  The plugs are inserted under magnification using the slit-lamp.  Usually a numbing drop is instilled in your eye just before placement.

Each of your eyelids has one tear duct.  The severity of your condition will determine if you need one or both tear ducts plugged.

Punctal plugs are a very effective and common method to treat dry eye.  Insertion is easy, painless and the plugs are usually well-tolerated and without complications.  Although complications are unusual, they plugs can easily be removed!

If you would like to consider punctal plugs for dry, please call us (202.686.6700) or email us to schedule an appointment with Dr. Paul Gavaris or Dr. Lauren Gavaris!

We look forward to meeting you.

The Doctors of Eye Associates of Washington, D.C.
Serving Washington, D.C. and Tysons Corner
Board Certified Eye Physicians and Surgeons