Effect of Collagen Punctal Occlusion on Tear Stability and Volume

  • Sudi Patel
  • David Grierson
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 350)


When the patient has dry eye symptoms, the clinician can apply several techniques to, evaluate tear status, the likely cause of symptoms, decide on appropriate therapy and monitor the progress and reaction of the eye. When the dry eye is the result of insufficient lacrimal output coupled with an abnormally high evaporation rate, the clinician can attempt to retain moisture at the ocular surface by blocking the lacrimal canaliculi. In this endeavour, occlusion of the inferior and/or superior punctum lacrimale has been applied for many years 1,2. Permanent occlusion can be produced by cautery. However, reversible occlusion is preferable and this can be achieved by inserting either a plastic or silicone plug of appropriate design. More useful arc intracanalicular implants manufactured out of processed collagen which have the property of self-dissolulion. They can be used as temporary ‘plugs’ which will help the clinician decide whether or not a more permanent occlusion is the better option. In the literature there are several anecdotal reports praising the punctal plug and reporting on patient satisfaction. There are very few studies reporting on objective changes in the tear film properties as a consequence of punctal or canalicular occlusion.


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  1. 1.
    C.H. Dohlman, Punctal occlusion in KCS. Ophthalmology. 85: 1277–1281 (1978).PubMedGoogle Scholar
  2. 2.
    R.M. Willis, R. Folberg, J.H. Krachmer, E.J. Holland, Treatment of aqueous deficient dry eye with removable punctum plugs, Ophthalmology. 94: 514–518 (1987).PubMedGoogle Scholar
  3. 3.
    S. Patel, J.C.Farrell, Age related changes in precorneal tear film stability. Am. J Optom & Physiol. Opt. 66: 175–178 (1989).CrossRefGoogle Scholar
  4. 4.
    C.W. McMonnies, Key questions in a dry eye history. J. Am. Optom. Assoc. 57: 512–517 (1986).PubMedGoogle Scholar
  5. 5.
    J.C. Parrell, D.J. Grierson, S. Patel, R.D. Sturrock, A classification for dry eyes following comparison of tear dunning time with Schirmer test. Acta Ophthalmol. 70: 357–360 (1992).Google Scholar
  6. 6.
    S. Patel, M.J.A. Port, Tear characteristics of the VDU operator. Optom. & Vis. Sci. 68: 798–800 (1991).CrossRefGoogle Scholar
  7. 7.
    M.J.A. Port, T.S. Asaria, Assessment of human tear volume. J. Brit. Cont. Lens. Assoc. 13:76–82 (1990).CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1994

Authors and Affiliations

  • Sudi Patel
    • 1
  • David Grierson
    • 2
  1. 1.Department of Vision SciencesGlasgow Caledonian UniversityGlasgowScotland, UK
  2. 2.Eye DepartmentRoyal Infirmary, Alexandra ParadeGlasgowScotland, UK

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