In people where eye drops did not work, eye doctors may use punctal plugs as a modality of dry eyes treatment. The idea of punctal plugs is to shore up what ever little tears are produced by preventing it from draining through the tear duct. In people with moderate to severe dry eyes, who can still produce tears, this treatment may increase the quality of their lives. The negative aspect is, using punctal plugs may result in allergic reactions to the materials used in the plugs causing the plugs to fall out, or result in eye infections.
There are different ways to plug up tear drainage.
1. Punctal Plugs
2. Thermocautery - use heat to close off the tear ducts permanently
3. Electorcautery - use electronic tool to seal off tear ducts
4. Laser ablation
5. Surgical cauterization- to close up tear duct.
Punctal plugs can be removed if neccessary, in case the person is allergic to the plug material or the plugs can fall out by themselves. About 50% of the plugs fall out within the first year. Methods 2-5 are permanent and cannot be reversed.
Punctal occulusion should be performed after surface inflammation is under control. 1
Before performing a procedure to occlude a punctum permanently, many eye doctors suggest a trial of temporary punctal occlusion using various plugs.4 While this is advised, being able to tolerate the temporary plugs does not give an accurate prediction of side effects of the permanent plugs.
The reported results of punctal plugs vary. It seems to work for people with dry eye of mostly mild to moderate severity. The magnitude of the treatment effect was more striking following implantation of non-dissolvable silicone plugs, but occlusion with temporary collagen plugs also had an apparent relief dry eyes.
Punctal Occlusion and Inflammation
Punctal plus has been shown to improve objective and subjective measures of dry eye12 , but may increase ocular surface inflammation in subjects with high levels of clinical inflammation.13 Because of this issue, an international panel of experts developing comprehensive treatment guidelines for ocular surface disorders recommended that the inflammatory condition be treated before punctal occlusion.14
Punctal Plugs and Increased Ocular Bacterial Infections
Because puntal plugs back up tears – which does not allow debri and bacteria from draining. Some people will see an increase in eye bacterial infections, which require anti-biotic eye drops for treatment.
Although punctal occlusion is an effective therapy for chronic dry eyes, there are complications related to punctal plug insertions. Some of these complications aree
- epiphora - over flow of tears onto the face.
- punctal ring rupture,
- abrasion of the corneal and conjunctival surface,
- suppurative canaliculitis - infection of lacrimal gland ( located at the upper and lower eye lids) causing surface abnormalities that sometime require surgical interventions.
For the right person, punctal plugs could work. Careful selection is critical evaluating risks and benefits. A variety of techniques are available. Punctal occlusion can dramatically improve the quality of life in many people with moderate cases of dry eyes and can prevent visual loss in people with severe cases of dry eyes
How TheraLife Eye can help!
TheraLife Eye is clinically proven to be 80% effective in dry eye relief for first time users. TheraLife Eye is effective when puntal plugs, prescription eye drop, eye drops failed. The reason is because TheraLife Eye work on restoring normal cell functions to tear secretion glands, intracellularly.
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1. American Academy of Ophthalmology. Punctal occlusion for the dry eye. Ophthalmology 1997; 104: 1521.
2. Freeman JM. The punctum plug: Evaluation of the new treatment for the dry eye. Trans Am Acad Ophthalmol Otolaryngol 1975; 79: 874–87.
3. Dohlman CH. Punctal occlusion in keratoconjunctivitis sicca. Trans Am Acad Ophthalmol Otolaryngol 1978; 85: 1277-1281.
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