Punctal plugs for dry eye

What it is

Tears normally drain away through small openings (puncta) in the inner eyelids. In dry eye, blocking these openings with small plugs keeps more of your own tears on the surface of the eye, improving comfort. It is usually considered when lubricating drops are not enough.

What happens

The procedure is done in a clinic in a few minutes.

• A quick check that plugs are suitable for your dry eye
• Soft or semi-permanent plugs gently inserted into the tear ducts
• Usually little or no discomfort and no need for stitches
• Temporary dissolving plugs are sometimes used first as a trial

Recovery and what to expect

You can usually return to normal activities straight away. Many people notice less dryness and grittiness and may need lubricating drops less often. Plugs occasionally fall out or can be removed, and rarely cause watering or irritation that is easily addressed.

When to consider and possible downsides

Plugs are usually tried after regular lubricating drops, warm compresses and lid care have not been enough. They work best when the main problem is tears draining away too quickly rather than not being made in the first place.

• Often considered after several weeks of consistent drop use and lid care
• Temporary dissolving plugs can test whether blocking drainage helps before a longer-lasting plug
• Occasionally cause too much watering if drainage is blocked more than needed
• Rarely trigger mild irritation or infection around the punctum, which is usually reversible
• Not usually the first step if inflammation or meibomian gland dysfunction is the main driver