David R. Benson, M.D., O.D.

David R. Benson, M.D., O.D., Eye Physicians of Lakewood

Caring for you, not just your eyes

Telephone: 253-584-1777

Eye Services

Dr. Benson's practice emphasis is on treatment of glaucoma, diabetic eye dises, macular degeneration, dry eye, and other eye problems in addition to providing quality eye care to all ages.

Eye Care Services at Eye Physicians of Lakewood

Meet Dr. Benson

Dr. Benson is both types of eye doctors: Optometrist AND Ophthalmologist. Practicing with the motto, "Caring for you, not just your eyes," he has been attending to his patients for more than 25 years.

Meet Dr. Benson at Eye Physicians of Lakewood

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FAQs about Eye Care at Eye Physicians of Lakewood

Dry Eye: Conserving Tears

The use of punctal plugs can be an effective step in treating moderate to severe dry eye that is unresponsive to artificial tear drops and ointments. The tears drain into the nose via the tear ducts and blocking this outflow is a reasonable strategy to keep the tears in the eye for a longer time.

The term 'puncta' refers to the opening of the tear ducts on the eyelid margin. Plugs that can be inserted inside the tear ducts to block them are called 'punctal plugs'. Punctal plugs increase the comfort level and lower the frequency of artificial tear use in most dry eye patients. The decreased artificial tear use may be economically beneficial, considering the high cost of preservative-free artificial tears.

Punctal plugs can be inserted either in the lower eyelid or in the upper eyelid or in both eyelids. Temporary punctal occlusion with collagen implants may be considered to ascertain if the punctal blockage will help reduce dry eye symptoms and also to rule out excessive tearing due to such blockage. Most silicone punctal plugs are umbrella shaped and top part of the punctal plug rests on the eyelid surface. A different type of punctual plug (Herrick plug ) is completely embedded within the tear ducts.

About 40% of punctual plugs are lost within 6 months of insertion. Most of the punctal plugs lost are due to spontaneous extrusion, and this happens usually within the initial 3 months post insertion. In addition, about 10% patients may complain of local discomfort at the plug site or excessive tearing (especially if both upper and lower puncta are blocked) and the punctual plug may have to be removed in these patients. This is a simple procedure and is painless. Patients who have lost the initial plug are twice as likely to lose the replacement plug. Upper punctal plugs have a higher risk of loss compared with plugs inserted in lower puncta.

A different type of punctal plug has been recently introduced. This punctal plug (marketed as SmartPLUG punctal plug by Medennium, Inc.) is made of a thermosensitive, hydrophobic acrylic polymer that changes from a rigid solid to a soft, cohesive gel when its temperature changes from room temperature to body temperature. Outside the punctum, at room temperature, the SmartPlug is a rigid rod. Forceps are used to insert the SmartPlug into the punctum. As the material inside the punctum rapidly warms, it shortens and expands in diameter, turning from a rigid rod into a gel-like plug, conforming to the size and shape of the punctum. Removal, if necessary, is accomplished with irrigation. Once inserted, no part of the SmartPLUG protrudes on the lid surface, therefore the potential to irritate or scratch the cornea may be less than the silicone plugs (which have a protruding cap).

Credits: http://www.agingeye.net/dryeyes/plugsetc.php