Punctal Occlusion Consent

Dr. Jilber Fouladian has recommended punctal occlusion to treat your dry eye symptoms. This procedure involves blocking the tear drainage ducts (puncta) to conserve your natural tears and prolong the effect of artificial tears.
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I. Procedure Description

Small, biocompatible plugs will be inserted into the puncta (tear drains) of your lower and/or upper eyelids.

• Collagen Plugs (Temporary): These dissolve naturally within 3-10 days. They are typically used as a diagnostic test to determine if occlusion improves your symptoms before placing permanent plugs.
• Silicone Plugs (Semi-Permanent): These do not dissolve and are designed to stay in place indefinitely, though they can be removed by the doctor if necessary.

II. Potential Risks & Side Effects

Punctal occlusion is a safe, reversible procedure, but potential side effects include:

• Excessive Tearing (Epiphora): If the eye retains too much fluid, tears may overflow onto the cheek.
• Foreign Body Sensation: A mild feeling of something in the eye, which usually resolves quickly.
• Plug Loss: Plugs may fall out over time and need replacement.
• Irritation/Inflammation: Mild irritation at the insertion site.
• Canaliculitis: Rarely, the plug may migrate deeper into the duct and cause infection (more common with intracanalicular plugs).

III. Benefits

Retaining natural tears improves comfort, stabilizes vision, and reduces the need for frequent eye drops. It can also improve the health of the ocular surface.
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IV. Financial Responsibility

Punctal occlusion is a medical procedure. While often covered by medical insurance for dry eye diagnoses, coverage varies by plan. I agree to be financially responsible for the cost of the procedure (including copays and deductibles) if it is denied or not covered by my insurance.