Are you sensitive to light? Do your eyes often feel gritty? Does your vision fluctuate? Does blinking improve your vision? Do you use artificial tear more than 3 times a day? Find your contact lenses uncomfortable? These are just a few of the most common symptoms we hear when patients tell us their eyes feel dry and irritated. Dry eye syndrome is very common, especially in women. Treatment of dry eye syndrome is very beneficial with very little risk of complications. Punctal occlusion with silicone plugs is one of the most common modes of treatment.
We often use punctal plugs to increase the amount of tears present in a patient’s eyes. A recent study compared the two most common types of punctal plugs, silicone punctal plugs and the SmartPLUG®. Essentially the study found that they both were relatively equally effective in reducing a patient’s symptoms (over 55% of the patients reduced the use of artificial tears). The study evaluated only 36 eyes for less than 12 weeks which really was not enough patients over too little time. However, one would likely expect that as long as the punctal plugs remained in the eyes the patients would continue to do well. The study does show that treatment of dry eye syndrome with punctal plugs is an effective solution.
Interestingly, 33% of the eyes treated had a plug fall out during the 12 weeks, which is very high. In our practice we see approximately 5% of our patients per year lose a plug, a rate much more in line with other ophthalmic practices. A 33% loss makes me want to look for a problem with punctal plug sizes.
We use both types of punctal plugs used in the study, silicone plugs (made out of a rigid type of silicone) and the SmartPLUG® (made out of a thermodynamic gel). We find both to be very effective and helpful in different situations. I like the silicone plugs for most patients, it is easy to insert and verify that it is still in place doing its job. The SmartPLUG® is helpful in patients that find the silicone plugs irritating.
If you think you are experiencing the symptoms of dry eyes see your eye doctor and get some help. There are numerous treatments available, which we will cover in another article. At a minimum, patients typically note a significant decrease in symptoms with treatment.
If you would like to read a summary of the article it’s available here “SmartPlug versus silicone punctal plug therapy for dry eye: a prospective randomized trial”.
UPDATE: Check out this video on treating Dry Eye Syndrome with punctal plugs at Total Eye Care.