Punctal Occlusion in Tear Deficiency Syndromes

A clinical procedure to predict the value of temporary occlusion therapy in keratoconjunctivitis sicca

“…Presumably this is due to the presence of a higher tear volume compared with baseline values. The improvement in patient symptoms following punctal occlusion is well documented (Freeman, 1975; Dohlman, 1978; Tuberville et al ., 1982; Willis et al ., 1987; Lemp, 1995; Murube and Murube, 1996). However, information on tear volume and stability is scant.…”

“…Blinking aids in maintaining the tear film and the removal of spent tears by initiating a pump action, which in turn draws fluid from the menisci into the lacrimal canals via the puncta. Thus, lacrimal punctal occlusion has been advocated as a therapy to promote tear stability by preserving the existing natural tears (Freeman, 1975; Dohlman, 1978; Tuberville et al ., 1982; Willis et al ., 1987; Giovagnoli and Graham, 1992; Murube and Murube, 1996; Virtanen et al ., 1996; Balaram et al ., 2001; Yen et al ., 2001). A provocative test, which would enable the clinician to decide if occlusion is the best way forward, would be of great benefit at the outset.…”

Lacrimal Punctum Occlusion in the Treatment of Severe Keratoconjunctivitis Sicca Caused by Sjögren Syndrome

“…19 Our results support the results reported in the literature. 4,5,9,17,19 In all these studies, the beneficial effect of punctum occlusion has been emphasized.…”

Clinical Guidelines for Management of Dry Eye Associated with Sjögren Disease

“…While there are no large-scale, prospective-controlled clinical studies on the efficacy of punctal occlusion, 76 reports in the literature for over 30 years strongly suggest that punctal occlusion can help decrease the signs and symptoms associated with KCS. [77][78][79][80] A comparison of punctal plugs versus artificial tears in the treatment of patients with keratoconjunctivitis and Sjögren disease demonstrated that both treatments greatly improved OSDI, corneal fluorescein staining, Schirmer test, and TFBUT scores compared to pretreatment levels. However, only the values of the Schirmer test scores and TFBUT were statistically more improved than the scores in the artificial tear group.…”