Are Punctal Plugs Good For Dry Eye?

May 30, 2018Dr. Travis Zigler

Punctal Plugs for Dry Eyes

I have punctal plugs (bottom only) and started with them 10 days ago. Now I have one eye that tends to overflow and the other one is still dry and sore. Does this mean the plugs are not working, or are they the wrong treatment?

I kind of think they are working in one eye and not working on the other. It seems like the eye that is overflowing is getting too much of a good thing. The eye that is still dry may not be benefitting as much. I see the overflow, commonly, when you didn’t address the inflammation first. So, your eyes are still really inflamed and therefore they are producing more watery tears and that watering keeps going. Now, it has got nowhere to go except for your cheeks, so it’s going to overflow. Your tears also have got a lot of enzymes in them and you may begin noticing a rash going down your cheeks because your tears will cause that. Alternatively, maybe one of the plugs fell out and that’s why that eye isn’t weeping as much.

If we ever do punctal plugs, which is pretty rare, we are always going to make sure that we clean up any inflammation in your eye first. That means really great lid hygiene, possibly putting you on a steroid eye drop for a little bit just to clear out any inflammation (because we know that if we are plugging up those glands, or plugging up those holes, your eyes are going to fill up with tears that are not good for your eyes). Address the inflammation first, and then consider punctal plugs.

One Love,