Do your eyes still feel dry, burning, or irritated—even with artificial tears?
If your eyes do not produce enough tears, punctal plugs may be a simple and effective way to help improve comfort and keep your eyes better lubricated.
At Eye Doctor MD, P.C., Dr. Pradhan uses punctal plugs as part of a personalized dry eye treatment plan to help patients find lasting relief.
What Are Punctal Plugs?
Punctal plugs are tiny devices placed into the opening of the tear ducts (called puncta), which are the small openings in your eyelids that drain tears away from your eyes every time you blink.
Punctal plugs work like small silicone drain stoppers—helping keep your natural tears on the surface of your eyes longer instead of draining away too quickly.
Punctal plugs do not change your tear production (which is from the lacrimal gland and goblet cells of your conjunctiva). Plugs only decrease your tear drainage. So if your eye was faucet, we are not turning off the water, we are only blocking the drain of the eye so more tears stay on the ocular surface.
This can help relieve symptoms such as:
- Burning
- Redness
- Grittiness
- Irritation
- Contact lens discomfort
- Blurry vision from dryness
Who Benefits Most?
Punctal plugs are often helpful for patients who do not make enough tears.
They are not typically recommended for patients who already have excessive watering, since blocking tear drainage can make watering worse.They may also not be ideal if there is significant inflammation on the ocular surface, since keeping inflammatory tears on the eye can worsen symptoms.
That’s why a full dry eye evaluation is important before deciding if punctal plugs are the right choice.
What Types of Punctal Plugs Are Available?
There are two main types:
Temporary (Dissolving) Plugs
These are often made of collagen and gradually dissolve over time. They may last from a few days to several months and are often used to test whether plugs will help. There is a new type of dissolving plug made from hyaluronic acid called Lacrifill® which slowly releases the compound on the ocular surface as well as blocks the tear duct over 4-6 months.
Semi-Permanent Plugs
These are usually made of silicone or medical-grade plastic and are designed to stay in place for years. They can be removed if needed.
How Are They Inserted?
Punctal plugs are placed right in the office and usually take less than 1–2 minutes per eye.
The process is quick, comfortable, and only requires numbing drops. Most patients return to normal activities immediately after placement.
They are also generally covered by insurance.
Are There Any Risks?
Like any treatment, punctal plugs do have possible side effects, including:
- Feeling scratchy at first
- Excess tearing or watering
- Plugs falling out (with the semi-permanent plugs)
- Tear duct irritation or infection (more so with the semi-permanent plugs)
- Rare scarring of the tear duct (more so with the semi-permanent plugs)
If needed, the plugs can be removed easily.
In some severe dry eye cases, doctors may recommend permanent tear duct closure (cautery) if plugs are not tolerated.
Are Punctal Plugs Right for You?
If artificial tears and other dry eye treatments have not given you enough relief, punctal plugs may be an excellent next step.
Dr. Pradhan carefully evaluates tear production, inflammation, and the root cause of your dry eye symptoms before recommending treatment. Dr. Pradhan had the semi-permanent plugs herself for 12 years before they fell out and they allowed her to wear contact lenses for her wedding. She also had the Lacrifill procedure herself in October 2025 and thinks it definitely helped her dry eyes. She has been performing punctal plugs for decades and the Lacrifill® procedure since February 2025.
Schedule Your Dry Eye Consultation
You do not have to live with uncomfortable dry eyes.
Call Eye Doctor MD, P.C. at (804) 270-3333 to schedule your dry eye consultation with Dr. Pradhan and learn whether punctal plugs may be the right solution for you.
Sometimes, keeping your own tears is the best treatment of all.