Punctual Plugs

Punctal plugs are another type of device designed to help provide relief from dry eye symptoms. They are small devices which are placed in the tear ducts (puncta) of the eyes, and help prevent fluid from draining from the eyes. This helps keep the surface of the eyes more moist, and to relieve the itching, burning sensations that come with dry eye.

Punctual Plugs in Olympia

What are Punctal Plugs?

Punctual plugs are tiny devices (about the size of a grain of rice) which are inserted into the tear ducts (puncta) of the eyes, which assist the draining of fluid from the eyes. This keeps the eyes more moist, which helps relieve the painful itching or burning which can come with dry eye.

These plugs are generally inserted in the puncta in the upper or lower eyelids (or both if necessary), and there is a different available plug type which is placed in another part of the tear duct (the canaliculus).

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When are Punctal Plugs Used?

Punctual plugs are used when patients are suffering from dry eye, which is when their eyes are not making enough tears or tears of poor quality, leading to dry, irritated eyes. Often, eyedrops are used to moisten the surface of the eyes and treat dry eye, but for some people having punctal plugs inserted can greatly increase their comfort.

Types of Punctal Plugs

Temporary/ Dissolving Plugs

These punctal plugs are made of a material which naturally breaks down over time and is safely absorbed by the body. (Collagen is often used for these.) This type of plug can remain in the eyes anywhere from a few days to several months, and are often used to help ensure the eyes remain moist following refractive surgery like LASIK (dry eye is very common following surgical procedures). They are also a good option for those interested in trying out punctal plugs to relieve dry eye without a long term commitment.

Semi-Permanent Plugs

Semi-permanent plugs are made out of a longer lasting medical plastic, and are designed to stay in the eye for years. They cannot be seen at all in the eyes, and can be removed by an ophthalmologist if the need arises.

Types of Punctal Plugs
How Are Punctal Plugs Inserted?

How Are Punctal Plugs Inserted?

The first step to getting punctal plugs inserted is for the doctor to examine your eyes to determine which type and size of plugs are best for you.

Then, either your tear ducts may be numbed (your doctor will determine if this is necessary, and the plug is placed into your eyelid. You might feel some pressure as the punctal plug is inserted, but discomfort should be minimal, and you should be able to resume normal activities immediately after the procedure.

How Are Punctal Plugs Inserted?

Possible Risks and Side Effects

As with all procedures and treatments, punctal plugs come with some potential risks and side effects.

The most commonly experienced minor side effect is an irritating or scratchy feeling in the corner of your eyes where the plugs are. In most cases, this feeling eventually goes away, or patients become used to it.

A more problematic side effect is that the plugs make your eyes overly watery with too many tears. If this occurs, the plugs may need to be removed or replaced with a different type.

It is uncommon, but possible for the plugs to move or come out of the eyes (usually as a result of rubbing the eyes.)

Punctal plugs can sometimes cause irritation of the tear ducts, leading to inflammation and swelling. If left untreated, this inflammation can lead to damage to the tear ducts.

If the plugs don’t fit properly, they can stick out of the tear ducts and cause irritation by rubbing against the eye or eyelid.

Eye infections due to punctal plugs can occur, though this is very rare. In such cases, treatment will be required for the infection, and your doctor may decide to remove the plugs.

If you experience any sort of side effect after receiving your punctal plugs, contact your doctor immediately for advice on what to do.

Which Patients Should Not Get Punctal Plugs?

Punctal plugs are not for everyone. Certain conditions can make it inadvisable to get them; your doctor will let you know if this is a case during your consultation.

Patients who have an active infection, issues with the drainage of the lacrimal system, or sensitivity to the material the plugs are made of, should not get punctal plugs. Additionally, if a patient has allergic conjunctivitis, punctal plugs should be avoided as they could result in allergens remaining on the ocular surface. Patients with severe blepharitis should also avoid punctal plugs.

When Are Punctal Plugs Removed, and What is the Process for That?

If certain serious side effects occur, your doctor may opt to remove your punctal plugs.

Most punctal plugs can be removed without surgery, by simply using forceps to pull them from the tear ducts or flushing them out with a saline solution.

Punctal plugs which were inserted deeper (inside the canaliculus) have to be surgically removed.

Types of Punctal Plugs
How Are Punctal Plugs Inserted?

Speak With Our Doctor About Punctal Plugs

If other treatments for dry eye, such as eye drops or artificial tears, haven’t done enough to relieve your symptoms, punctal plugs may be what you need. Contact American Family Vision Clinic at (360) 491-2121 to schedule a consultation today. Following an examination, our doctor will be able to make a recommendation for you.

Dr. Zurcher cartoon


Punctal plugs are devices that can be inserted into the tear ducts to help relieve dry eye symptoms. If you would like to learn more about punctal plugs or schedule a dry eye exam at American Family Vision Clinic, call (360) 491-2121. Patients with dry eyes visit our clinic from all over Washington, and we are proud to be a leading provider of dry eye care for patients from Olympia, Lakewood, Tacoma, and Lacey.

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Such a nice optician. My grandson is only 4 and needs glasses. We were so sad, but he explained the issues, and we will follow up as he suggested.

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Dr. Zurcher has gone above and beyond what any other eye doctor has ever done to figure out what is going on with my eyes. Very happy with American Family Vision.

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Family Vision Clinic changed our lives! My daughter was frequently car sick, and she was getting headaches every day, often painful enough that they brought her to tears. We saw a string of doctors and therapists, but we made no progress. Finally, we found Dr. Levi Zurcher and his eye therapist Rain. After ten weeks of eye therapy my daughter no longer gets headaches, and she no longer gets car sick. Daily tears are a thing of the past. I really can’t say enough about this clinic. It was fascinating to watch Dr. Zurcher work. For the first time, someone who knew what they were doing was intently studying my daughter, really trying to figure out all of her eye issues, and his therapist Rain is one of the most patient and lovely people that I’ve ever had the good fortune to meet. We’re finished with eye therapy—yay!—and I have switched to American Family Vision Clinic for all of my family’s other eye health needs.

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Very professional, yet kind and helpful. They do what they can to make the appointment comfortable. I was running a bit late, I made sure ti call. They were able to switch me with a patient who was already there, they treated me with respect, and helped my son have confidence by getting him the eye care he needed that day. Thank you so much! Would recommend to anyone. It's a blessing that they care enough to work with people who have all different types of insurance from work to state coverage.

Justin E.

The staff is friendly. The Doc is very knowledgeable. The office is family friendly and everyone is so patient with the little ones.

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