Tears help keep the eyes relieved. When you have dry eyes, your eyes do not produce enough tears or the produced tears are of poor quality. The punctal plugs, especially if other treatments are not effective, are possible treatment for the dry eye. The procedure of placing punctal plugs is called the punctal occlusion.
The placement of the punctal plug is a procedure of treating the dry eye. Many people suffer from dry eye owing to the fact that their eyes do not produce enough tears or proper quality of tears. Tear drops are usually used for the dry eye treatment. However, some people think that placing punctal plugs in their eyes will help them feel comfortable.
What is Punctal Plug?
Punctal plug is a tiny device placed inside of tear ducts called puncta in the eye. Puncta are tiny gaps which transfers tears in the eyes. The plug, about the size of a grain of rice, blocks the liquid from draining from the eye. This helps the eye surface stay moist and relieved, and it also relieves the itchy, burning, red eye.
Punctal plug is also called tear plug. The plugs are usually placed in puncta of top or bottom eyelids or placed in both. Another type of plug is placed in a deeper part of the tear duct. There are two types of punctal plug. These are:
- Temporal and Dissolvable Plugs
- Semi-permanent Plugs.
Temporal and dissolvable plugs are made from a material that breaks up slowly and absorbs by the human body. These plugs can stay in the eye from a few days to months. Temporal plugs are usually used to keep the eye moist after having refractive surgery. These plugs are, also, designed to stay in the eye for years. If needed, they can be removed by an ophthalmologist. Another type of semi-permanent punctal plug is placed a deeper part of the tear duct called canaliculus. These plugs are not visible to eye.
Which Department is Responsible for the Punctal Plug Placement?
The idea behind the punctal occlusion is simple: to increase the aqueaus component of tear film by blocking the tear out. Punctal occlusion helps patient keep their tears on occular surface. This interference is highly effective and it is usually used after proving environmental testing, drop therapy, omega 3 supplement, and topical prescriptive eye drops are insufficient.
Preferably, after taking control of the surface inflammation amongst the occlusion methods includes thermocautery, electrocautery, laser ablation or direct surgical occluding. The method of the placement of the punctal plug is applied by eye clinics.
What is the Placement of Punctal Plug?
Punctal plug, also called the lactimal plug , is a small device used for treating the dry eye syndrome. Dry eye syndrome is also known as chronic dry eye. If there is dry eye syndrome, eyes can not produce enough quality tears to lubricate the eyes. Dry eye symptoms include:
- Burning
- Scratch
- Blurry Vision
Ongoing dryness provides to produce more tears, however, these are mostly water and can not moist the eyes enough. This way, eyes shed more tears than they can hold, and it usually causes overflowing.
If you shed a lot of tears and your eyes get watery a lot, it may be the sign that you have dry eye syndrome. Dry eye syndrome can be treated with some lifestyle changes and using artificial tears sold unprescribed. However, the most effective method is the punctal plug placement.
How to Place the Punctal Plug?
In the method of punctal plug placement, first of all, an ophthalmologist will examine the eye to find the most suitable plug in type and size. The doctor may anesthetize the tear canals. In some cases anesthetizing may not be necessary. Since the punctal plug is placed on the eyelid, some pressure may be felt. After the plugs are placed, the patient can usually return to their normal activities immediately.
Before placing the punctal plug, a comprehensive eye examination is required. The patient and the doctor, if both agree on the idea that punctal plugs are the best option, need to decide the type of plug. Temporary punctal plugs are made of collagen and dissolves a few months later. The plugs made with silicone are aimed to last years.
Plugs are in different sizes, therefore, the doctor needs to measure the tear canal gap. There is no need for general anesthesia. Actually, there is nothing to be done to prepare for the procedure.
The Punctal Plug Placement
As it has in some treatment or procedure the placement of the punctual plug may have some risks and side effects. The most common side effect is a scratchy or irritating feeling in the corner of the eye. Many people, realizes that the feeling is gone or they get used to it.
- Punctal plugs can water the eyes a lot with tears. The plugs may have to be removed or changed to a different type for a better tear control.
- Plugs can usually move or come out of the eye due to eyes rubbing.
- Plugs that do not fit properly may come out of the tear duct and rub against the surface of the eye or eyelid.
- Sometimes punctal plugs can irritate the tear canals. Plugs can cause eye redness, swelling, and inflammation. Ongoing inflammation can injure the tear canals and damage them.
- Some eye infections can appear even though it is rare. Some infections may need to be treated with antibiotics. The ophthalmologist may want to remove the plugs.
What are the Advantages of Placing Punctal Plugs?
Punctal plugs are often used in people whose dry eye cannot be relieved despite maximum lubrication. Instead of applying artificial tears, placing punctal plugs help preserve remaining natural tear fluid, which has by far the best wetting and nutrient capacity for the ocular surface.
The punctal plug placement can preserve the integrity of the ocular surface, corneal transparency and visual acuity by preserving the patient’s own tears by blocking the tear drainage system, by increasing tear volume and decreasing tear osmolarity. It has the ability to prevent vision loss and improve lifestyle in people with moderate or severe dry eye.
The Period after Placing Punctal Plug
There is no recovery time after punctal occlusion. The person, after the punctal plug placement, can go home by themselves and continue their normal activities such as driving. Many people can not feel the occlusion or if they can feel it, it is not uncomfortable. Temporary plugs dissolve on their own in a few months. Dry eye problem can, again, come back. If this happens and the plugs are helping, the permanent one can be a better option for you.
Your doctor will give you instructions about how often you should come. If you have severe dry eye or infections due to punctal plugs, your doctor may have to check you a few times a year.
The considerations to be considered after the placement of the punctal plug are:
- Eyes should be rested often.
- If the person works on a computer they should make sure to blank enough and have breaks sometimes.
- A humidifier should be used to keep indoor air moist.
- An air filter should be used to minimize the dust.
- You should avoid wind. You should not be exposed to fans, ventilation holes or other blowers that can dry the eyes.
- Eyes should be lubricated all the time. Preservative-free eye drops can be used several times a day.
- Eyes should be protected outdoors by wearing well-fitting glasses or sunglasses.
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