Treating Dry Eyes with Punctal Plugs: Silicone Plugs vs the SmartPLUG®

RAD — Fri, 30 May 2008 23:19:05 +0000

Are you sensitive to light? Do your eyes often feel gritty? Does your vision fluctuate? Does blinking improve your vision? Do you use artificial tear more than 3 times a day? Find your contact lenses uncomfortable? These are just a few of the most common symptoms we hear when patients tell us their eyes feel dry and irritated. Dry eye syndrome is very common, especially in women. Treatment of dry eye syndrome is very beneficial with very little risk of complications. Punctal occlusion with silicone plugs is one of the most common modes of treatment.

We often use punctal plugs to increase the amount of tears present in a patient’s eyes. A recent study compared the two most common types of punctal plugs, silicone punctal plugs and the SmartPLUG®. Essentially the study found that they both were relatively equally effective in reducing a patient’s symptoms (over 55% of the patients reduced the use of artificial tears). The study evaluated only 36 eyes for less than 12 weeks which really was not enough patients over too little time. However, one would likely expect that as long as the punctal plugs remained in the eyes the patients would continue to do well. The study does show that treatment of dry eye syndrome with punctal plugs is an effective solution.

Interestingly, 33% of the eyes treated had a plug fall out during the 12 weeks, which is very high. In our practice we see approximately 5% of our patients per year lose a plug, a rate much more in line with other ophthalmic practices. A 33% loss makes me want to look for a problem with punctal plug sizes.

We use both types of punctal plugs used in the study, silicone plugs (made out of a rigid type of silicone) and the SmartPLUG® (made out of a thermodynamic gel). We find both to be very effective and helpful in different situations. I like the silicone plugs for most patients, it is easy to insert and verify that it is still in place doing its job. The SmartPLUG® is helpful in patients that find the silicone plugs irritating.

If you think you are experiencing the symptoms of dry eyes see your eye doctor and get some help. There are numerous treatments available, which we will cover in another article. At a minimum, patients typically note a significant decrease in symptoms with treatment.

If you would like to read a summary of the article it’s available here “SmartPlug versus silicone punctal plug therapy for dry eye: a prospective randomized trial”.

UPDATE: Check out this video on treating Dry Eye Syndrome with punctal plugs at Total Eye Care.

Q: Why are my eyes so dry lately?

RAD — Fri, 25 Jan 2008 22:14:53 +0000

A: Many conditions can contribute to dry eyes, including both your health and your, environment. Are you near any ceiling fans or heaters? Does your car’s heater or air conditioner blow directly on your eyes? Some medications, such as antihistamines, decongestants and diuretics can also contribute to dryness. Hormone changes, such as those attributed to pregnancy or menopause may also be a factor. Some people have a condition called blepharitis, where their lids become dry and flaky, this too can contribute to dryness. Other people may be suffering with “Sjogren’s Syndrome”, which is an autoimmune disorder where the mucous membrane glands are attacked causing significant dryness and discomfort.

Your optometrist can evaluate the source of your dry eyes and initiate a treatment plan. Dry eye syndrome is very common and can be successfully treated. In addition to eye drops there are many new solutions for the treatment of dry eyes that don’t require the use of eye drops.

The Eye Doc Blog » sjogren syndrome

Treating Dry Eyes with Punctal Plugs: Silicone Plugs vs the SmartPLUG®

Q: Why are my eyes so dry lately?