The tear film in the human eye is a very complex fluid. It is secreted by various glands around the eye. The tear film has mechanical, lubricating action and protects the eyes from harmful bacteria, allergens and other infecting substances. All of us develop less thick tears after age 40. This process is progressive, and by the time we reach our 70’s or 80’s, the tear flim is rather watery and does not act as an effective barrier against scratching of the eyes or bacterial invasion.
As this is a common problem, we feel that everyone should use artificial tears if they have chronic wet, scratchy, itchy or burning irritated eyes. The first line of defense is using artifical tears at bedtime and first thing in the morning. When artificial tear supplementation does not give sufficient relief, making better use of the body’s own tears is often an effective treatment mode. This can be accomplished by blocking the drainage of tears from the eyes with punctual plugs. After an evaluation is done with several tests to establish the quantity and character of the tear film, plugs can be placed in the puncta that drains tears from the ocular surface and retention of a better tear film can be achieved. In most cases, a trial of temporary plugs is done before going forward with non-dissolvable ones.