How Using Punctal Plugs Can Be Beneficial for Your Practice

Eric Brooker, OD

This educational article is also available as a downloadable PDF.

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Punctal plugs help in developing a specialty dry eye practice

It may be surprising, but many optometric doctors do not utilize punctal occlusion in their practices. This billable medical procedure can easily distinguish the average optometric practice into a specialty dry eye clinic.

Punctal plugs allow patients to recognize the expertise of the optometrist as a medical dry eye specialist

Utilizing a value-added treatment for patients that are suffering from aqueous deficient dry eye syndrome builds patient loyalty and appreciation for the advanced skills of a trained optometric specialist.

Punctal plugs increase revenue reimbursements

An optometric general examination has an average reimbursement of approximately $70; however, reimbursement for a patient returning for a medical eye exam with occlusion of all four puncta can be up to $255, three times more revenue than one annual examination. Adding this procedure into the general flow of an optometric clinic can significantly increase medical insurance reimbursements with very little capital investment.

Punctal plugs improve contact lens patient retention and fitting success

Dry Eye Syndrome is one of the most common reasons for contact lens dropout patients. Untreated dry eye conditions cause contact lenses to dry out and decrease the amount of comfortable wear time in a given day. Patients perceive the under performance of their contact lenses as either a failure of their candidacy to wear contact lenses or a failure of their doctor to properly fit the patient in the optimal contact lens. Either perception has a negative outcome for the optometric clinic. Alternatively, identifying dry eye conditions early and utilizing treatments such as punctal occlusion can assist patients in having optimal performance of their contact lenses and therefore, prevent patients from discontinuing contact lens wear.

Punctal plugs aid in optimal postoperative refractive surgery and cataract outcomes

One major reason for poor refractive outcomes from LASIK or cataract surgery is untreated Dry Eye Syndrome. Patients may perceive post-operative dry eye as a failure of the procedure. Treating dry eyes pre-operatively and optimizing the ocular surface may improve the accuracy of surgical measurements and allows for improved vision and recovery.

Punctal plugs treat dry eye aggravated by allergic triggers

The creation of the 90-day synthetic extended plugs is an excellent solution for patients that suffer from seasonal allergies that can flare up and disrupt the tear film. The 90-day synthetic extended plug is intracanalicular so it does not disturb nasal chemosis that can be present in patients that suffer from regular seasonal allergic conjunctivitis. Inserting a temporary plug allows the doctor to improve tear volume when needed at certain time frames during the year.

Punctal plugs benefit patients to be less dependent on eye drops and OTC eye drops that contain preservatives

Patients consistent use of OTC eye drops that contain preservatives can aggravate a dry eye condition and cause damage to the ocular surface. Punctal occlusion increases the overall tear volume and can decrease a patient’s consistent dependence on lubricating eye drops.

Punctal plugs improve patient compliance for treatment with dry eye disease

Utilizing punctal occlusion requires patients to return for follow ups to assess effectiveness of the treatments. Consistent interaction with the doctor reiterates the importance of compliance and improves the outcomes of the therapeutic treatments.

Punctal plugs help in increased referrals from medical specialists such as rheumatologists

Medical specialists like Rheumatologists can be an excellent source of dry eye patient referrals. These patients have usually already been treated with multiple types of eye drops and continue to suffer. Punctal occlusion can be a great solution for patients with Rheumatic conditions. Positive outcomes reflect back to the Rheumatologist who, in turn, is more likely to send additional patients suffering from dry eyes and autoimmune disorders.

Punctal plugs encourage patient in-house referrals

When successfully abating patients’ dry eye condition and dependence on lubricating eye drop usage, patients are usually excited and surprised that their condition has finally improved. Satisfied patients are motivated to tell family and friends of the optometrist’s expertise and commonly refer them to the optometric clinic resulting in the best type of referral and in-house marketing.