What is Punctual Occlusion?

At times, the need for artificial tears can interrupt daily life and create a problem with patient compliance. Many times a patient becomes tired of using frequent eye drops throughout the day and ointments before bed. Patients requiring treatment but wanting relief from frequent drops are candidates for "Punctal Plugs". As the name suggests, Punctal plugs occlude (block) the punctum, or tear duct, which carries tears and debris away from the surface of the eye. There are upper and lower punctum ducts in the inner corner of each eye. Blocking these drainage ducts prevents tears from draining away too quickly. Punctal occlusion can be compared to putting a stopper in a sink drain. Although delicate, this specialized procedure is safe, quick, and totally reversible. Punctal occluders are made of a very soft flexible silicone, carefully manufactured into an extremely smooth and precise design. Our doctors utilize the "Parasol" Punctal Plugs from Odyssey Medical. Parasol plugs are one of the most advanced occluder systems available, and is widely utilized within the Eyecare industry.

The Procedure

Instillation typically includes a prophylactic drop of antibiotic to flush the tear duct. A single drop of anesthetic is then instilled to briefly anesthetize the eye. Gently securing the implant with a pair of forceps, and using a high-powered magnification device called a slit-lamp, our doctors will line the plug up with the patient's punctum and delicately position the plug into the tear duct. The patient will then sit for about 10 minutes and be re-evaluated to insure that the plug is secure. Follow up will occur in about 11 to 15 days. The follow up visit will assess the position of the plug, the health of the cornea, and the amount and quality of tear in the eye. Patients usually notice the most improvement at about day three.

What are the risk factors for Punctual Occlusion?

Punctal occlusion is an extremely safe procedure. Although rare, risk factors may include infection within the tear duct, a dislodged plug, or eye irritation from contact with a portion of the plug. Because of the reversible nature of this technology, these risk factors are treated with simple plug manipulation or removal, or the application of an antibiotic eye drop.