Two types of plugs
Punctum plugs can be inserted in the lower eyelid, upper eyelid, or both. Before your eye care practitioner inserts a plug, he/she will measure the opening of your tear duct to determine the size of plug that you will need to block your tear duct. He/she will sometimes use topical anaesthetic drops (numbing drops) before the procedure, but in many cases, anaesthesia is not needed. The exact way your eye care practitioner inserts the plug depends on the design and shape. Some plugs come with special inserters, but other types are inserted with forceps or other instruments. The location of insertion also depends on the type of plug. You can see some plugs after they are inserted. Others are inserted deeper into the tear duct and will not be visible when you look in the mirror.
You may have some mild discomfort while the punctum plugs are inserted, but it will be very brief. Most people cannot feel the plugs once they are in place. You can resume normal activities and drive yourself home immediately after the procedure.
Temporary plugs dissolve naturally and do not require removal. Permanent plugs do not need to be removed unless you are bothered by them or develop an infection (which is extremely rare).
Removing punctum plugs is usually very easy
Punctal plugs rarely cause serious side effects, but they do have some risks. Possible risks include: