Eye Surgery

Punctal Implants

The Answer To Dry Eye
Tears do much more than help us express emotion.

The bulk of the tear film is excreted by the lacrimal (tear) gland, which lies just under the upper brow bone. To keep the external eye moist, tears are swabbed over the eye with every blink. Blinking also acts to pump the tears through an intricate drainage system, starting with the puncta. The puncta are tiny oval-shaped openings, one in the upper and one in the lower lid, at the inner corner of the eye. These openings lead to the canaliculi, tiny tubules, which drain into the nasolacrimal sac. From here the tears are conducted to the back of the throat (which is why you taste your tears).

If the cornea (clear window over the eye) is allowed to dry it may ulcerate, leading to scarring and possibly blindness. Dry eye is a clinical entity where either not enough tears are produced, or the tears that are produced are of poor quality.

Dry eye has a paradoxical nature. Innervation connects the external eye and the lacrimal gland. When the eye gets dry, a message is sent to the brain. The brain, in turn, notifies the lacrimal gland. The lacrimal gland tends to over-react. Instead of sending just enough tears to do the job, there is a gush of tears which frequently streams down the face. “What do you mean I have dry eyes?” the patient demands. “They water all the time!”

While supplemental artificial tear drops and ointments are the most-often prescribed treatment for dry eye, there is another option. Tiny plastic plugs can be inserted into the puncta. These punctal plug implants stop up the drainage system, keeping the tears that are produced exactly where they are needed...on the eye.