Punctal plugs

What are punctal plugs? How successful is the use of these? Do these help in anyway reducing the effect of glaucoma?How long a person has to wear them? Is there any alternative to these e.g. medicine, ointment?

[Joan M Pernoud, MD]

Punctal plugs are little devices about the size of a piece of ground coffee which can be easily placed in the small opening in the inner part of the eyelid which then closes off the ourflow drainage from the eye. The eye has two of these...one of the upper eyelid and one in the lower. These are most commonly used for treatment of dry eyes so the tears can stay on the surface of the eye instead of draining down into the nose.

One does not see them or feel them (with few exceptions). The newer kinds can be easily removed so it is reversible if ever needed. They are usually meant to be permanent and they help reduce the symptoms of dry eye in many people but they are not a magic wand......just an additional tool for people with dry eyes. Some people advocate using these in people with glaucoma if their pressures are under marginal control. The purpose is to help keep the medication on the front of the eye longer for better absorption.

Regarding dry eyes, they just help reduce the need for artificial tears in many cases. Maybe a patient would only need artificial tears 2 times a day rather than 4. I have them myself. I don't see any downside.