The punctum is the entrance to the tear duct and is found on both the upper and lower eyelid. It is easiest to think of it like a plug hole the which the tears need to drain to reach your tear duct and then your nose.
In some cases the punctum is too small. This may prevent the tears from draining which can give you a watery eye.
When punctal stenosis is present we may need to enlarge your punctum by excising a small part of the tear duct. This is called a punctoplasty.
A punctoplasty is usually performed in the treatment room in clinic. It is performed under local anaesthetic and will take about 5 to 10 minutes.
A small piece of the punctum is removed to allow the tears to pass more easily.
The tears should then start to drain more easily.
This will not usually lead to any visible scar but you may have a small bruise at the inner aspect of your lower eyelid for a few days.
After the surgery we will review you in clinic and may re-probe the tear duct with some anaesthetic drops. This ensures that the punctum does not close up afterwards.
You will have some drops to take for about two weeks.
There are relatively few complications with this surgery. The main risk is that the eye may perstistently water afterwards. As with any surgery around the eye there is a theoretical risk of trauma to the eye or vision.
Author: Mr Jonathan Norris FRCOphth