Side Effects of Punctal Plugs: Part I

Dozens of pharmaceutical commercials about dry eyes play on television or the radio. Ophthalmologists often use punctal plugs, also called lacrimal duct plugs, for this diagnosis.Punctal plugs are tiny devices that fit snugly in the tear ducts or puncta of the eye. The plug completely blocks the duct and prevents tears from draining. This allows the moisture in the eye to stick around longer and lubricate the eyes. Patients rarely have major complications from the plugs, but they can fall out or slip out of position.Patients with dry eyes may have chronic aqueous tear deficiencies or have other ocular issues such as keratoconjunctivitis, keratitis, or recurrent corneal erosions. They may try artificial tears, but these can be cumbersome and expensive. Studies have suggested using the plugs as a simple and effective alternative for dry eyes. (Cornea. 2002;21[2]:135; http://bit.ly/2DuuCo5; Am J Ophthalmol. 2001;131[1]:30; http://bit.ly/2XBM5m0.)A punctal plug.Three types of plugs are available—collagen, silicone, and intracanalicular—and it's important to know their basic differences. All are placed by an ophthalmologist, and the lacrimal ducts occasionally need to be dilated during placement. Sometimes, the plugs fall out or loosen. Collagen plugs dissolve over time, and silicone and intracanalicular plugs last longer. Patients usually have silicone plugs, which look like flat white discs sticking out of the lacrimal duct; intracanalicular plugs extend into...
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