If your main problem is low tear volume i.e. aqueous deficient dry eye (ADDE), then punctal plugs are an option. Punctal plugs, as the name suggests, block the drainage channel of the eyes (punctum) to prevent tears draining away. The theory is that by keeping what little tears there are in the eye the dry eye symptoms can be reduced. Before trialling the punctal plugs we will treat any MGD (meibomian gland dysfunction) and reduce any sign of inflammation. If this isn’t done then all you are doing is trapping all the inflammatory products in the eye which can make the eye even more uncomfortable. The other risk is that if the tears are prevented from leaving the eyes in the normal way then excess tears may just run out over the cheek which is very annoying.
We always do a trial with collagen plugs first. The collagen plugs gradually dissolve over a few days. The obvious advantage is that you get to experience how your eyes will feel without making a permanent decision. If they are successful we place permanent plugs in the punctum which last around 6-12 months. They are a very effective option for the right person.
Scleral Lenses for Dry Eye