Hello, this is Goyang Shinsegae Eye Clinic.
Tears are a natural physiological response that helps protect the eyes.
However, if tears frequently well up or run down your cheeks even without emotional changes or external irritation, it may be necessary to look beyond a simple temporary reaction and check whether there is a problem with tear production or drainage.
Although excessive tearing may seem to occur simply because too many tears are being produced, it can actually be associated with various causes, including dry eye syndrome or problems with the tear drainage pathway.
Therefore, if these symptoms continue to recur, it is important to accurately evaluate the condition of the eyes.
1. How Are Tears Produced?
Tears are continuously produced by the lacrimal glands, which are located in the upper outer area of the eyelids.
As we blink, tears spread evenly across the cornea and conjunctiva, helping keep the surface of the eyes moist and protecting them from various external irritants.
Afterward, the tears naturally drain into the nasal cavity through small openings called the puncta, located near the inner corners of the upper and lower eyelids.
In this way, tear production, circulation, and drainage must remain properly balanced to maintain a healthy ocular environment.
However, if a problem occurs at any stage of this process, dry eye syndrome may develop or existing dryness may become worse.
2. What Is Punctal Occlusion?
Punctal occlusion is one of the commonly used nonsurgical treatment options for dry eye syndrome.
A small medical-grade silicone plug is inserted into the punctum, which is the opening through which tears normally drain.
This allows tears to remain on the surface of the eye for a longer period of time.
By increasing the amount of time tears stay on the ocular surface, the tear film may become more stable, helping protect the surface of the eye and relieve symptoms associated with dryness.
3. Why Is Punctal Occlusion Performed?
1) Relief of Dry Eye Symptoms
Punctal occlusion helps moisture remain on the surface of the eye more consistently.
As a result, it may help relieve not only dryness but also other symptoms associated with dry eye syndrome, such as a foreign-body sensation, stinging, burning, or sensitivity.
2) Maintaining a Stable Tear Film
A stable tear film helps protect the cornea and conjunctiva.
This may also help reduce damage to the ocular surface caused by excessive dryness.
3) A Relatively Simple Procedure
Punctal occlusion can generally be performed in an outpatient setting within a relatively short period of time.
The plugs are made of medical-grade materials designed with biocompatibility in mind.
If necessary, they may also be removed depending on the ophthalmologist’s assessment.
4) Barely Noticeable From the Outside
The inserted plug is very small and is positioned within the punctal area, so it is usually not noticeable in appearance.
4. How Is the Procedure Performed?
✓ Eye Examination
First, a slit-lamp examination may be performed to evaluate the severity of dry eye syndrome and check the position and size of the puncta.
Depending on the condition of the eyes, additional tests such as tear film evaluation or ocular surface examinations may also be performed to assess the eye more thoroughly.
✓ Selection of an Appropriate Plug
Based on the examination results, a plug that is suitable for the size of the patient’s punctum and overall eye condition is selected.
✓ Insertion of the Plug
Using a dedicated instrument, the selected plug is carefully inserted into the punctum.
✓ Position Check and Completion
After confirming that the plug is positioned properly, the procedure is completed.
If there are no particular problems, patients can generally return to their normal daily activities afterward.
However, it is important to follow the ophthalmologist’s instructions and precautions according to the individual condition of the eyes.
5. Precautions After the Procedure
Excessively touching or rubbing the eyes may cause the plug to become dislodged or change position.
Therefore, after the procedure, it is important to avoid rubbing the eyes forcefully or repeatedly irritating the area around the puncta.
If you wear contact lenses, it is advisable to follow your ophthalmologist’s guidance regarding when to resume lens wear and how to manage your lenses after the procedure.
Depending on the condition of the eyes, you may be advised to avoid wearing contact lenses for a certain period immediately after treatment.
Most patients adapt without significant discomfort.
However, if persistent foreign-body sensation, pain, severe redness, or increased discharge occurs, an ophthalmic examination may be necessary to check whether the plug has shifted or whether inflammation has developed.
