Punctal Occlusion

Introduction

“Dry eye” describes a medical condition in which the eyes do not produce a sufficient quantity of tears to keep the eyes healthy and protected. The eyes produce two types of tears that serve different purposes. Lubricating tears are comprised of a precise balance of mucous, water, oil, antibodies, and proteins that come together to protect the surface of the eye. Reflex tears, on the other hand, are produced as an emergency response to sudden irritation, and flood the eye. However, they do not have the same protective qualities as lubricating tears.

Dry eye occurs when the eye does not produce enough lubricating tears. Ironically, one of the symptoms of “dry eye” is excessive watering or tearing of the eyes with reflex tears, which are triggered in response to the irritation caused by inadequate lubricating tears.

Punctal Occlusion

While there are a number of treatments for dry eye, severe cases may require a special procedure called a punctal occlusion to be fully corrected. This procedure seeks to help the eye harness and use what little lubricating tears they are capable of producing. The procedure accomplishes this by using small “plugs” to block, or occlude, the punctum, which is a small, funnel-shaped drainage hole in the corner of the eye. By blocking the punctum, the lubricating tears that are produced by the eye are allowed to stay there, protect the eye, and not drain away.

Punctal occlusion can be performed as both a permanent or a temporary solution, depending on which type of plugs your physician uses. Collagen plugs are temporary and will dissolve over time, while silicone plugs are permanent and will stay in place, occluding the punctum forever. The punctum can also be closed with heat- or laser-based procedure, which aims to scar the punctum closed. Typically, if you experience relief with a temporary punctal occlusion, your physician will recommend you pursue a permanent version of the procedure, either with silicone plugs or a laser-based procedure.  

What to Expect

Punctal occlusions are an office-based procedure. On the day of your case, you will come to the office and drops will be used to numb your eye without the use of needles or injections. Your physician will use a small applicator to push the plug into place and ask you to blink to ensure it is placed correctly.  Your Center for Sight physician with discuss the complications and risks with your prior to the procedure.

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