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Punctal Occlusion

An effective dry eye therapy to retain more of your natural tears

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I-Plug Punctal Occlusion Therapy

Punctal occlusion therapy is a treatment for dry eye disease caused by lacrimal dysfunction or aqueous (water) deficient dry eye. 


Our tears are produced by the lacrimal gland under the upper eyelid, spread over the surface of the eye, and drain out of the eye through the tear duct punctum). For many patients with dry eye disease, a lack of tear production leads to chronic irritation and damage to the ocular surface.

Punctal occlusion helps to relieve red, burning, itchy eyes associated with dry eye disease.

How Punctal Occlusion Works

Punctal occlusion therapy involves the insertion of a small, medical device (punctal occluder) into the tear duct (punctum). Punctal occlusion helps to decrease tear drainage & allows the eye to remain lubricated for longer periods of time. Your optometrist may recommend punctal occlusion of the lower and/or upper tear duct.


Two types of punctal occluders are available: absorbable collagen occluders and non-absorbable silicone occluders. Temporary collagen occluders can be used as an initial test treatment and dissolve naturally within 1-2 weeks. The silicone punctal occluders remain within the tear duct as long as treatment is required; however, can be removed at any time.

I-Plug Placement

I-Plug punctal occlusion therapy is quick, simple, and painless. During the office visit:

  • The patient is comfortably seated on the examination chair at the slit lamp 

  • Prior to the start of the treatment, a topical anesthetic eye drop is instilled into each eye

  • The upper and/or lower punctum is measured in order to ensure ideal I-Plug sizing

  • The I-Plug punctal occluder is placed using the pre-loaded I-Plug applicator

  • Placement of the I-Plug punctal occluder takes only a few minutes and is completely painless

  • The patient can return to their regular daily activities immediately after the treatment

Punctal Occlusion Efficacy

Punctal occlusion therapy is extensively studied and has been available for more than 30 years. During this time, the design of punctal occluders has improved significantly - increasing their effectiveness.


Many studies have shown improvements in dry eye symptoms, tear volume, and tear stability after punctal occlusion. These improvements can last 6 to 12 months or more depending on the type of punctal occluder used.


Patients who do not produce enough of the aqueous (water) component of the tear film are best suited for punctal occlusion therapy. Specific measurements are taken during your dry eye evaluation in order to determine if you are a good candidate punctal occlusion.

An effective dry eye therapy to retain more of your natural tears.

The results of several clinical studies have shown:


on average

of patients feel improvement of dry eye symptoms



increase in natural tear volume


up to

of patients reduce the use of lubricant eye drops

2 months after initial treatment

Dr. Graehem Sayer

Punctal Occlusion Therapy

Punctal occlusion therapy is a very helpful treatment for certain types of dry eye disease. This treatment option has been researched extensively and has been available for over 30 years; however, many optometrists no not prescribe punctal occlusion therapy for their dry eye patients.

The majority of dry eye patients will benefit from treatments that help improve the oil component of the tears, such as Lipiflow or E-Eye IRPL; however, punctal occlusion therapy is quite effective to increase tear volume for anyone who is unable to produce an adequate aqueous (water) tear layer. Patients who benefit most from punctal occlusion therapy include post LASIK or cataract surgery dry eye, and dry eye associated with inflammatory or auto-immune conditions such as Sjogren's syndrome. 

I often find myself prescribing punctal occlusion therapy as a final step of the dry eye treatment plan and have seen synergistic benefits with our other dry eye treatment options.

Please don't hesitate to contact me with any questions regarding the punctal occlusion therapy or call our office to schedule a consultation to see if you may be a candidate.

Dr. Graehem Sayer

LUX Eye Care

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Check out our other dry eye treatments:

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