Treatment of dry eye with punctal plugs.

Dry eye syndrome is a common finding for which treatment with artificial tears and sterile ointments is often satisfactory. In cases that do not respond to conventional therapy, it may be necessary to employ punctal plugs. Following dilation of the lower and upper puncta, temporary collagen implants are inserted, and the patient is asked to return within a few days for reevaluation. If dry eye symptoms have been significantly diminished, silicone plugs may be inserted in the lower puncta and the patient monitored for about a month before determining if occlusion of the upper puncta is also necessary. Extrusion of plugs and foreign body sensation are the most common complaints accompanying the procedure. Although intra-canalicular plugs have been developed to achieve semi-permanent occlusion, no controlled studies have yet been performed to determine their efficacy.