What are punctal plugs and cautery?
The eyes have four drains, called puncta, through which tears (which are constantly renewed) exit. These are in the lower and upper corners of the eyelids nearest the nose. For patients whose dry eye symptoms are caused primarily by a deficiency in the water (aqueous) part of their tears, stopping the drains (called punctal occlusion) can sometimes help improve the symptoms. There are two ways to do this: using small plugs, or permanently sealing the openings with cautery. There are also temporary collagen plugs, which dissolve by themselves, which can be placed in order to test the likelihood that silicone plugs or cautery will be helpful and will not result in tear overflow (epiphora).
