Punctal plugs are designed to retain moisture in the eyes. The plug is placed by a doctor into the tear duct. Plugs come in different sizes and in different styles. The ones selected for you should be based on your condition and anatomy, not on the availability of the plug. Your doctor may recommend blocking one or more tear ducts with punctal plugs, depending on the degree of aqueous deficiency in each eye.
Some people are able to tolerate plugs easily, whereas others feel the plugs and are not able to tolerate them. Plugs can fall out or become lodged in the tear duct. With plugs there is always a risk of infection.
Punctal Plugs vs. Cautery
Plugs are sometimes preferred over punctal cautery because they require only numbing drops to place them, and because of the ease of reversing the plugging. All the doctor has to do is pull out the plug. Some people who are sensitive to the preservatives in numbing drops may opt to have the plugs placed without numbing drops.
Some individuals are not able to tolerate punctal plugs, in which case they should be avoided.
Other complications can occur with punctal plugs.
It is not uncommon for punctal plugs to fall out.
References
Inferior punctal occlusion with removable silicone punctal plugs in the treatment of dry-eye related contact lens discomfort
Giovagnoli D, Graham SJ.
Journal of the American Optometric Association
1992 Jul;63(7):481-5.
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Punctal occlusion for Dry Eye Syndrome
Ervin AM, Law A, Pucker AD
The Cochrane database of systematic reviews
2017 Jun 26; 6:CD006775. Epub 2017 Jun 26.
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Safety and efficacy of lacrimal drainage system plugs for Dry Eye Syndrome: a report by the American Academy of Ophthalmology
Marcet MM, Shtein RM, Bradley EA, Deng SX, Meyer DR, Bilyk JR, Yen MT, Lee WB, Mawn LA.
Ophthalmology
2015 Aug;122(8):1681-7. doi: 10.1016/j.ophtha.2015.04.034. Epub 2015 May 30.
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