In-Office Procedures · Treatment
Punctal Plugs
Punctal occlusion keeps the patient's own tears and the drops you prescribe on the eye longer. It is a mainstay for aqueous-deficient dry eye, best placed once surface inflammation is under control.
Key points
- Occluding the puncta slows tear drainage and increases tear residence time.
- Dissolvable collagen plugs suit a short trial before committing.
- Silicone and intracanalicular plugs provide longer-term occlusion.
- We stock a deep line of plugs, inserts, and sizing instruments.
What it is
Punctal plugs are small inserts placed in the lacrimal puncta, or deeper in the canaliculus, to reduce tear outflow. They range from temporary collagen plugs that dissolve over days to weeks, to semi-permanent silicone plugs that sit at the punctum, to intracanalicular inserts placed within the drainage system.
How it works
Tears normally drain through the puncta into the nasolacrimal system. Occluding the puncta slows that drainage, so the eye retains more of its own tears and any artificial tears or medicated drops stay on the surface longer. In aqueous-deficient disease, where tear production is the limiting factor, that conservation can meaningfully reduce symptoms.
The science and sequencing
Punctal occlusion is a recognized step in the staged management of aqueous-deficient dry eye. The usual sequence is to control ocular surface inflammation first, then occlude, so that the tears you are retaining are healthier rather than inflammatory. A dissolvable plug is a low-risk way to trial the response before placing a long-term plug. Consistent with TFOS DEWS III management framework.
Where it fits
Consider occlusion for aqueous-deficient or mixed dry eye that drops alone do not control. Hold off when significant surface inflammation is uncontrolled, since you do not want to retain inflammatory tears against the surface.
The Dry Eye Rescue line
The wholesale platform carries a deep punctal range, including Lacrivera VeraPlug, the Eagle Vision family (SuperEagle, SuperFlex, EaglePlug, and collagen inserts), and DuraPlug, plus sizing and dilating instruments so you can fit accurately.
Sources: TFOS DEWS III management framework for aqueous-deficient dry eye; Dry Eye Rescue product catalog.
Trial a dissolvable collagen plug first to confirm symptom relief, then place a longer-term plug once you know it helps.
Frequently asked questions
What plugs do you carry?
Lacrivera, Eagle Vision, DuraPlug, and more, across dissolvable and long-term options, plus sizing and dilating instruments.
Temporary or permanent first?
Many practices trial a dissolvable plug to confirm benefit before placing a longer-term plug.
When should I hold off?
Hold occlusion when significant ocular surface inflammation is uncontrolled, so you are not retaining inflammatory tears.
Do plugs fall out?
Punctal plugs can be lost or extrude over time, which is one reason a sized fit and a trial plug are useful. Long-term options vary in retention.
Do I need sizing tools?
Accurate sizing improves retention and comfort. We carry punctal gauges and dilating instruments alongside the plugs.
