Punctal Occlusion

Dry Eye Disease is a very common condition. Studies suggest that more than 16 million American adults are diagnosed with this eye disease each year. In a healthy eye, the meibomian glands, lacrimal gland, eyelids, and tear ducts all work together to maintain sufficient moisture for ocular health and comfort. The tear film must contain a precise ratio of aqueous, mucin, and lipids in order to prevent dryness, grittiness, and other uncomfortable sensations. The tear film is moved across the eye by the eyelids. When you blink, the motion of your eyelids moves tears to the eye’s natural drainage system, the tear ducts, or, technically, the lacrimal punctum. If your tear film is evaporating too quickly, your doctor may consider performing what is called punctal occlusion.

One way to alleviate dry eye is to help the eyes to make better and longer use of the small amount of lubricating tears they do produce. This is accomplished by closing off the small funnel-like drain hole found in the inner corner of the upper and lower eyelids. These drain holes, called punctums can be closed with tiny plugs called punctal plugs. The plugs can be placed in the two tear ducts, top, and bottom, in both eyes, or in only the lower ducts. The punctum can also be permanently closed with a heat or laser procedure.

Punctal plugs can be temporary or permanent. Temporary plugs dissolve a few days after insertion. If your dry eye symptoms disappear when the temporary plugs are inserted, your doctor may consider permanent punctal occlusion.

The accomplished doctors at Central Valley Eye Medical Group provide a high standard of care in a friendly, comfortable environment. If you are struggling to maintain control over your dry eye symptoms, contact us at 1-800-244-9907. We proudly serve patients in Modesto, Stockton, Manteca, and surrounding areas! 

What is Punctal Occlusion?

Punctal occlusion is a conservative eye procedure that blocks the puncta, the small drainage tube through which tears exit your eyes. With the tear ducts blocked, your ocular surface has more tear film at any given time. Your eyes will still drain tears naturally, just not as quickly. Punctal plugs are made in various shapes and sizes, ranging from 0.3 mm to 0.7 mm in diameter. They are made of biocompatible materials so pose very little risk of irritation or allergic reaction. The punctal occlusion procedure is performed right in the office without any need for sedation or anesthesia. The doctor may apply numbing eye drops to your eyes before beginning the brief procedure. This way, you will not feel any discomfort whatsoever. To determine the perfect size and shape of punctal plug, your doctor will use a special instrument to measure your tear ducts. There is one tear duct on the upper eyelid and one on the lower eyelid of each eye. Depending on your needs, your doctor may insert a punctal plug into each or only in the lower eyelids. The entire treatment process takes just a few minutes. 

Punctal occlusion is for those:

  • who have been diagnosed with dry eye
  • whose doctor has determined that punctal occlusion is the appropriate treatment for their condition

Who is a Candidate for Punctal Occlusion?

If you are having a difficult time managing the symptom of dry eye disease, you may be a good candidate for punctal occlusion. Your doctor must perform a thorough review of your medical history to confirm your general health and also confirm that you do not have an eye condition that may increase the risks of the procedure. If punctal occlusion is not ideal for your situation, your experienced eye doctor will discuss other options for addressing your symptoms.

How to Prepare for Punctal Occlusion Procedure?

The punctal occlusion procedure is a conservative treatment to help you manage the symptoms of Dry Eye more effectively. There are no incisions or major manipulation of the eye, so you need not take any special precautions beforehand. 

How Soon After the Procedure Will You Notice the Results?

You may begin to notice improvement from your punctal plugs within one week of your procedure. That said, it may take up to a month to see the full effects of your treatment. The time it takes to feel better can vary based on the severity of the condition and the symptoms it has caused. The doctor may be able to estimate their expectations after performing a full examination of your condition and your eyes. 

What Are the Benefits of Punctal Occlusion?

The purpose of the punctal occlusion procedure is to reduce your Dry Eye symptoms by preserving the tear film on the ocular surface. By preventing tears from draining too quickly, punctal occlusion treatment can restore comfort and productivity. The painless procedure takes very little time and does not require you to make significant changes in order to recover. Once the punctal plugs are inserted, you should quickly get used to them. Over time, the plugs may dissolve naturally, after which you can have new plugs inserted if you so choose. 

Why Choose Central Valley Eye for Your Punctal Occlusion?

Central Valley Eye is the only ophthalmology practice in our area in which every physician is fellowship trained. Being fellowship trained means that our doctors have spent additional time to master their specialty. It also demonstrates a strong commitment to providing the utmost care. As a result of their extensive training, our doctors are regularly invited to lecture at prominent medical conventions and to respected educational societies, groups, and institutions. They have authored chapters in ophthalmic resources used by doctors around the world, and also remain actively involved in teaching local resident physicians. When you choose Central Valley Eye, you are putting your eyesight and eye health in the hands of very capable specialists!

What Type of Results Can You Expect from your Punctal Occlusion?

Punctal occlusion is somewhat of a test to see how a person’s body responds to blocking drainage from the eyes. Some people achieve remarkable results from the insertion of punctal plugs while others see minimal improvement. It is difficult to predict exactly how you might experience change after your procedure. Your doctor will do their best to explain how the procedure works, what can happen afterward, and how they think your eyes can improve. With this information, you can make an educated choice about your treatment options. 

Is Punctal Occlusion Safe?

Punctal occlusion is generally considered a safe and effective treatment for dry eye disease. There are a few risks associated with the procedure, but it is important to understand what they are. Though uncommon, the following may occur after punctal occlusion treatment:

  • A gritty or scratchy feeling may develop around the punctal plug
  • The eyes water excessively due to an overabundance of the tear film on the ocular surface
  • Redness and swelling may occur as a result of irritation in the tear ducts
  • The punctal plugs may not remain in place
  • Infection occurs near the punctal plugs

What is the Recovery and Aftercare for Punctal Occlusion?

One of the benefits of this office procedure is that you do not need to take time off for recovery. You can expect to feel well enough to drive yourself home and resume normal activities immediately following your treatment. The punctal plugs are generally so small that they are not felt in the eye. If you do feel something different, you should get used to the new sensation very quickly. Your doctor may advise you to continue treating your dry eye symptoms as usual.

How Long Will the Results of My Punctal Occlusion Last?

There are two common types of punctal plugs, collagen, and silicone. Collagen punctal plugs are designed for temporary use. These biocompatible plugs will dissolve naturally in as little as a few weeks or as long as several months. Silicone punctal plugs are not dissolvable. These are made to last indefinitely, though they can be removed at some point if necessary. Your doctor can discuss their anticipated outcome based on the type of plug that is best suited to your needs.


If you would like to learn more about Punctal Occlusion call 1-800-244-9907 to make an appointment at Central Valley Eye Medical Group.


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