Punctal Plugs: What It Is and What to Expect
Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor provides Punctal Plugs?
An ophthalmologist, an eye doctor who treats eye problems, places punctal plugs. Punctal plugs are tiny devices that are placed in the eye's tear ducts. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What it is
Puncta are the tiny openings in your eyelids that drain tears from your eyes. A punctal plug is about the size of a grain of rice, and it blocks tears from draining from the eye. This helps keep the surface of the eye moist and comfortable. Punctal plugs are also called punctum plugs, lacrimal plugs or occluders.
There are two main types of plugs.
- Temporary plugs are made of a material, such as collagen, that gradually breaks down and is absorbed by the body.
- Semi-permanent plugs are made of longer-lasting medical plastic, such as silicone or acrylic.
Another type of semi-permanent plug is placed in a deeper part of the tear duct called the canaliculus.
Why a doctor might recommend it
Dry eye is when your eyes do not make enough tears or the right quality of tears. Eye drops are often used to treat dry eye. If artificial tears or other eye drops have not relieved your dry eye symptoms, your ophthalmologist may recommend trying punctal plugs. Temporary plugs are often used to keep the eye moist after refractive surgery, such as LASIK. They are also used when you want to try out punctal plugs to see if they help relieve your dry eye.
How to prepare
First your eye doctor will examine your eye to figure out the best type and size of plug for your needs.
What happens during it
Your doctor may numb your tear ducts with anesthesia. In some cases, you may not need to have your eyes numbed. You may feel some pressure as the punctal plug is placed in your eyelid. Plugs can be placed in the upper eyelids, the lower eyelids, or both. Most plugs are placed with a tool called an inserter, which guides and releases the plug.
Recovery
After the plugs are inserted, you are usually able to return to your normal activities right away. If you feel any eye pain, or if you think you have an eye infection, tell your eye doctor right away. Your doctor may choose to remove the plugs.
Risks and side effects
Most people find punctal plugs do not cause any problems. The most common side effect is a scratchy or irritating feeling in the corner of your eye. Many people find this feeling goes away or they simply get used to it.
Other side effects and risks include the following.
- Your eyes may become watery from too many tears.
- Plugs may move or come out of the eye, usually from rubbing your eyes.
- A plug that does not fit properly could stick out of the tear duct and rub against the surface of your eye or eyelid.
- A plug can irritate the tear duct and may cause redness and swelling.
- Some types of eye infections can occur, though rarely.
If your eyes become too watery, the plugs may need to be taken out or replaced with a different type. Ongoing inflammation, which is redness and swelling, can scar or damage the tear ducts.
Who performs it
Semi-permanent plugs can be removed by your ophthalmologist if needed. To remove silicone plugs, an eye doctor can use forceps to gently pull them from the tear duct. Another way is to flush them out with a salt water solution. Plugs that are deeper in the tear duct, in the canaliculus, are removed with surgery.
Common questions
What does it feel like to get punctal plugs?
You may feel some pressure as the plug is placed in your eyelid. Your doctor may numb your tear ducts with anesthesia.
How long do punctal plugs last?
Temporary plugs can last in the eye from a few days to months. Semi-permanent plugs are designed to stay in the eyelid for years.
Do punctal plugs help dry eye?
Some people with dry eye find that punctal plugs make their eyes more comfortable. Eye doctors may recommend trying plugs when eye drops have not relieved dry eye symptoms.
How does a direct primary care or concierge doctor fit in?
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance.
Sources
- American Academy of Ophthalmology - Punctal Plugs
- American Academy of Ophthalmology EyeWiki - Punctal and Canalicular Occlusion Devices
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
