Cornea Procedures
Pterygium Surgery
Superficial Keratectomy
Phototherapeutic Keratectomy (PTK)
Punctal Plugs
Artificial Cornea
Implantable Miniature Telescope (for Macular Degeneration)

Punctal Plugs

Punctal occlusion with plugs may be used to treat "dry eye" symptoms and corneal disease associated with aqueous tear deficiency.

The punctum is a small opening at the nasal lid margin which collects and drains tears with each blink. Tears drain into the nasolacrimal duct system, which empties into the back of the nose (like our sinuses). Patients with a blockage of the nasolacrimal system will have excess tearing (although there are other reasons for excess tearing). On the other hand, a punctal plug may be placed to minimize drainage, boosting the  tear film that bathes the ocular surface, thus minimizing symptoms.

The procedure is performed in the office and takes only a few minutes. There is minimal , if any, discomfort associated with the procedure.  The punctal plug is a small (less than 1 mm), biocompatible device that is barely visible to the naked eye. There are multiple types of plugs. Dr. Koreishi prefers the "umbrella" design. A small portion of the plug is visible above the punctal opening when examined under the slit lamp microscope. This visibility also facilitates removal if discomfort or side effects occur.

Side effects and complications are rare. Occasionally a patient may experience excess tearing or significant irritation, in which case the plug can be removed.  If the plug becomes displaced or lost, it can be replaced with a larger size if necessary.  Infection is a very rare complication that can be treated with topical and/or oral antibiotics, with or without removal of the plug.
Although punctal plugs are helpful in the right situation, the procedure is not the best option for everyone, especially if inflammation is present. Other treatments are sometimes necessary prior to, or instead of, punctal plugs. Your doctor will examine each patients' eyes thoroughly to determine the best treatment course. If plugs are suggested, the procedure can sometimes be performed at the same office visit (if insurance allows).

Each patient's eye is different. The description above may not apply to every individual situation. Your doctor will perform a full evaluation and discuss her findings thoroughly. A treatment regimen will be planned and re-evaluated throughout follow-up visits. Please contact your doctor if you feel you have dry eyes or if you have any concerns or questions regarding your ocular health. 

As cornea specialists in DFW, Dallas-Fort Worth, Dr. Koreishi and Dr. Ple-plakon strive to provide the best cornea care, availability, and patient education. Now open Plano Cornea.


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