The Jackson Davenport Vision Center Team
Comparing prescription eye drops and punctal plugs for dry eye starts with the cause: the National Eye Institute notes that "treatment for dry eye usually depends on what's causing your symptoms." Prescription drops work by different mechanisms: some calm inflammation, some slow evaporation, and some stimulate tear production. Punctal plugs slow tear drainage so the tears you already make stay on the eye longer. The two act on different things. The American Academy of Ophthalmology notes, of dry-eye treatments in general, that many people find it necessary to combine therapies; that is not a recommendation to combine these two options.
Too Few Tears, or Tears That Dry Up Too Fast
The American Optometric Association describes tears as three layers: oil, water, and mucus. As the AOA's dry eye page puts it, "a smooth oil layer helps prevent evaporation of the water layer, while the mucin layer spreads the tears evenly over the surface of the eye." The oil comes from the meibomian glands in the eyelids. The water comes from the tear glands.
The AOA notes that people with dry eyes either do not produce enough tears or their tears are of poor quality:
- Not enough tears. Tear production tends to diminish with age, with various medical conditions or as a side effect of certain medicines.
- Tears of poor quality. The AOA says tears may not spread evenly over the eye when any of the oil, water or mucus layers is deficient; without a healthy oil layer, tears also evaporate off the surface too fast.
Where Artificial Tears Fit
The National Eye Institute says, "The most common treatment for mild dry eye is a type of eye drops called artificial tears." As the American Academy of Ophthalmology puts it, artificial tears "don't treat the underlying causes," and the AOA states that "people with dry eyes that don't respond to artificial tears alone will need to take additional steps to treat their dry eyes." Inadequate relief from artificial tears can have several explanations, and sorting out which one applies to you is what an eye exam is for.
What Prescription Eye Drops Do
The National Eye Institute's dry eye page explains: "If your dry eye is more serious, your eye doctor may give you a prescription for medicines called cyclosporine (Restasis) or lifitegrast (Xiidra). These medicines are both types of eye drops that can help your eyes make more tears."
The American Academy of Ophthalmology describes several FDA-approved prescription treatments for dry eye, and they work in different ways:
- Cyclosporine (Restasis) — which the AAO says was developed "specifically for chronic dry eye where inflammation leads to reduced tear production."
- Lifitegrast (Xiidra) — an anti-inflammatory drop.
- Perfluorohexyloctane (Miebo) — a drop aimed at evaporation, which the AAO describes on the linked page as stabilizing the tear film and slowing evaporation.
What Punctal Plugs Do
Your tears drain. According to the American Academy of Ophthalmology's punctal plugs page, puncta "are the tiny openings in your eyelids that drain tears from your eyes," and punctal plugs "are tiny devices that are placed in the eye's tear ducts." The National Eye Institute describes when they come up: "If tears are draining too quickly from your eyes, your doctor may suggest putting special plugs (called punctal plugs) in your tear ducts... These plugs can help keep your tears in your eyes."
The AAO describes two kinds:
- Temporary plugs are made of a material such as collagen that gradually breaks down and is absorbed by the body. They can last from a few days to months, and they are also used to try out punctal plugs.
- Semi-permanent plugs are made of a longer-lasting medical plastic such as silicone or acrylic and are designed to stay in the eyelid for years. The AOA notes that silicone or gel-like plugs "can be removed if needed."
Before placing plugs, the eye doctor examines the eye to choose the type and size. The AAO lists possible side effects; this summary is not exhaustive. The most common is a scratchy or irritating feeling in the corner of the eye. Plugs can also make the eyes watery with too many tears, may move or come out of the eye (usually from rubbing the eyes), and may cause redness and swelling in the tear duct; some types of eye infection can occur, though rarely.
Prescription Eye Drops and Punctal Plugs Side by Side
- What it is — Prescription eye drops: a prescription medication; the AAO describes several FDA-approved drugs for dry eye. Punctal plugs: tiny devices placed in the eye's tear ducts.
- What it acts on — Prescription eye drops: inflammation, evaporation, or tear production, depending on the drug. Punctal plugs: how fast the tears you make drain away.
- When it comes up — Prescription eye drops: the NEI says an eye doctor may prescribe cyclosporine (Restasis) or lifitegrast (Xiidra) if your dry eye is more serious. Punctal plugs: the NEI says a doctor may suggest them if tears are draining too quickly from your eyes.
They are different options with different mechanisms, and which one an eye doctor suggests depends, in the AAO's words, on "what your eye exam and testing shows."
What a Dry Eye Evaluation Looks At
The National Eye Institute notes that your doctor can check for dry eye as part of a comprehensive dilated eye exam. According to the AOA, testing "with emphasis on the evaluation of the quantity and quality of tears produced by the eyes" may include a patient history covering symptoms, general health problems, medications, or environmental factors; an external examination of the eye, including lid structure and blink dynamics; evaluation of the eyelids and cornea using bright light and magnification; and measurement of the quantity and quality of tears, where special dyes may be put in the eyes to better observe tear flow.
About Jackson Davenport Vision Center
The practice's two optometrists, whom you can read about on our doctors page, are Dr. Christopher Holstead, O.D. and Dr. Alyssa Davenport, O.D. Her profile on our doctors page says that while in school, she developed a deep understanding of dry eye and low vision. Both practice at our one office, at 218 Old Trolley Road in Summerville, and the page for our eye doctor in Summerville lists the office hours and address. The practice has 4.8 stars across 225 Google reviews as of October 22, 2026.
The practice offers emergency office visits; the emergency office visits page explains how the office handles them and how to reach us.
Book an appointment, or call the office at (843) 871-9750.
This article summarizes the side effects the American Academy of Ophthalmology lists for punctal plugs; it does not list the side effects or limitations of prescription eye drops, and it does not compare the safety of the two options. It is general information, not medical advice, and is not a substitute for an exam by a licensed eye doctor.