Punctal occlusion in keratoconjunctivitis sicca.

Occlusion of the lacrimal puncta is a useful and underutilized procedure in the treatment of keratoconjunctivitis sicca. When artificial tears no longer ameliorate symptoms and the Schirmer tests are 2 mm/5 min or less (repeatedly), combined with positive rose bengal staining, punctal occlusion is indicated. Diathermy is the most practical technique for permanent closure, whereas various punctum plugs can be applied for a temporary effect.