Punctum (or Punctal) Plug

The punctum plug is a small silicone or collagen plug that is inserted by an eye doctor into a tiny skin opening (punctum) in the eyelid that drains tears away from the eye. This procedure is often used to help alleviate a problem called dry eye, which occurs when the lacrimal glands don't produce enough tears or produce tears of the wrong composition to properly lubricate and protect the eye from dust and irritants. The plugs simply hold the tears in the eye for a longer period of time. Eyes must remain moist to be healthy.

Tears flow into the eye from the lacrimal glands located under the upper eyelids and are spread over the surface of the eye by blinking. The used tears then drain from the eye through the puncta (plural of punctum), which are located near the nose. From there they are channeled into the nasal cavity where they are either swallowed or drain through the nostrils.

Dry eye can develop under many circumstances and is caused by an alteration in the eye's natural tear film and/or by a reduction in tear production. It is often the result of the natural aging process, as the eye tends to become drier with age. Dry eye is accompanied by stinging, burning, itching, dryness, redness, and possible infection and corneal scarring if left untreated. It can be aggravated by contact lenses.

Dry eye can be treated with artificial teardrops and lubricating ointments to supplement the eye's natural tears. If the problem persists, the next line of treatment may include the insertion of punctum plugs that partially close the tear drainage system. The plug is very small - about the size of a sesame seed - and insertion takes just a few minutes in the doctor's office.

There are two types of punctum plugs. One is a collagen plug that is designed to dissolve and be absorbed by the body in 4 to 7 days. These plugs are most often used as a diagnostic tool to determine whether more permanent plugs might be beneficial in solving the dry eye problem. The plug is placed in the tear drainage canal and allows only a small amount of tears to pass into the nasal passage, thereby building up layers of tears on the surface of the eye. The amount of time it takes for the plugs to dissolve gives the doctor enough time to evaluate the problem and properly diagnose dry eye.

The other type of punctum plugs are silicone, and they are designed to be permanent, but can be removed if necessary.

There are other long-term solutions to the problems created by dry eye, but punctum plugs are the least invasive because they do not involve surgery.