The “puncta” is the hole in which tears drain away from the ocular surface, down your nose and throat. If we need to preserve the volume of tears on the ocular surface, then we may choose to slow the drainage but plugging the puncta. There is a drainage port in both the upper and lower lid, however we typically only plug the lower lids.
You may have had “plugs” in the past. Punctal occlusion is a treatment that has been around for decades, however it is not always appropriate. If your tear film is contaminated then blocking the drainage will increase this contamination and toxicity to the surface. This is why some patients report that plugs “didn’t help.”
We use a special plug that is placed just inside the puncta. This means you will never feel the plug and you cannot lose the plug if you rub your eyes inadvertently. These plugs are made from collagen, something your body produces naturally, and will dissolve in six months. For those needing long-term occlusion, we do have silicone plugs as well.
Punctal occlusion typically takes less than one minute and is completely painless.