68761 Closure of the lacrimal punctum; by plug, each

Name of the Procedure:

Closure of the Lacrimal Punctum by Plug, Each

Summary

This procedure involves inserting a small plug into the lacrimal punctum, which is a tiny opening in the corner of the eye where tears drain into the tear ducts. The plug is used to block the tear duct, helping to keep more moisture on the eye's surface.

Purpose

The procedure aims to address dry eye conditions by conserving tears on the eye surface. By blocking the tear ducts, more tears remain in the eye, reducing dryness and irritation.

Indications

• Symptoms of chronic dry eyes, such as burning, dryness, itching, and redness
• Sjogren's syndrome or other conditions causing reduced tear production
• Patients who have not responded adequately to other treatments like artificial tears

Preparation

• No special fasting or medication adjustments are generally required.
• A thorough eye examination and possibly a tear production test (Schirmer's test) may be performed beforehand.

Procedure Description

1. The eye is numbed with anesthetic eye drops.
2. A tiny plug is selected and inserted into the lacrimal punctum using a specialized applicator.
3. The process is repeated for each punctum being treated.

Duration

The procedure typically takes around 10-15 minutes to complete.

Setting

This is an outpatient procedure often performed in an ophthalmologist's office or an eye clinic.

Personnel

An ophthalmologist or an optometrist usually performs the procedure, assisted by a nurse or a clinic technician.

Risks and Complications

• Common: Mild discomfort, temporary irritation, or a sensation of something in the eye.
• Rare: Plug displacement, infection, or tearing of the punctum. In some cases, the plug may migrate or require removal.

Benefits

• Immediate relief from dry eye symptoms.
• More comfortable and prolonged moistness of the eye's surface.
• Reduced need for artificial tears or other medications.

Recovery

• Minimal downtime, with most patients resuming normal activities immediately.
• Patients should follow up with their doctor to ensure the plugs are in place and working effectively.
• Avoid rubbing the eyes vigorously to prevent dislodging the plugs.

Alternatives

• Artificial tears and lubricating eye drops.
• Prescription medications to increase tear production.
• Permanent punctal cautery (surgical closure of the tear duct).

Patient Experience

• Minimal discomfort is expected during and after the procedure.
• The patient might feel a slight pressure or mild irritation initially.
• Pain management is usually not necessary as the procedure and recovery are generally pain-free. Comfort measures, such as avoiding eye strain, can enhance recovery.