Fouad Melamed, OD Los Angeles Eye Doctor

Punctal plugs are a very effective treatment for dry eyes, when other treatments have been less than effective. Dry eyes can be more than a minor inconvenience for patients. It can be very painful.

Punctal plugs are not generally a first line treatment for dry eyes. Your eye care professional will need to make a definitive diagnosis first. Then other treatments may be tried to evaluate your response.

If these other treatments aren’t giving you the relief you need, you may be a candidate for punctual plugs. Here is how they work. Your eyes have lacrimal glands that produce the liquid or “tears” that bath the eye. Tears keep the eyes moist and help rid the eye of small particles of dust, dirt and pollutants.

These tears normally exit the eye through the tear ducts that are located in the upper and lower lids of the eyes at the bridge of the nose. You can see the puncta or openings on the inside of the lids. A small portion of tears are lost to evaporation also.

Punctal plugs are placed in these tear duct openings to keep the tears in the eyes. This dramatically decreases the amount of tears lost due to drainage. Increasing the amount of tears in the eyes and thus the lubrication will make the eye feel better.

Punctal plug insertion generally involves two different insertion procedures. The first insertion will be temporary plugs. This temporary plug will allow your doctor to evaluate how well this procedure is going to work for you. Occasionally, patients will have excessive tearing of the eyes when the puncta are plugged.

These temporary plugs will generally last 10 days to a few months. This is enough time for both you and your doctor to evaluate the effectiveness of punctal plugs for you. Punctal plugs are easily inserted and can easily be removed if necessary in your doctor’s office.

Your eye will first be numbed with an eye drop. Then the punctal plug will gently be inserted in the puncta using a sterile instrument. The procedure takes about a minute to perform. Your doctor will discuss with you prior to the procedure which type of plugs will be inserted. Upper and lower tear ducts can be plugged in this manner. Your doctor may elect to do just the lower ducts, or all four may be plugged.

Patients generally have no discomfort with this procedure and tolerate the plugs well. Plugs are tiny and not visible to others.  Although the plugs are designed to be permanent, plugs do come out on occasion. Your Los Angeles eye doctor can insert another plug if this happens.

If you are bothered by dry eyes, be sure to discuss punctal plugs with your eye care professional. If your Los Angeles eye doctor does not put them in, a referral can be made to an eye care professional that places punctal plugs. Comfort can be one small procedure away.

“Doctor, I think I have Pink Eye!” The term “pink eye” is actually a general term used by patients for a variety of inflammations of the conjunctiva. What we optometrists and eye doctors look for is a more specific diagnoses and cause of what is causing your eyes to become red/pink, watery, painful, or itchy.

Pink Eye or Conjunctivitis can be allergic, bacterial, or viral.In many cases, it is just an irritated eye from a very common condition called Dry Eye Syndrome. A corrected diagnoses is important because that’s what is needed in order to get a correct treatment.

Patients usually (and unsuccessfully) attempt to treat themselves with over the counter medication or unfortunately finding and using “any eye drop” in the drawers at home. This usually does not solve the problem and in many cases can make things worse.

To watch a short video on this topic visit, Pink Eye on our website.

The important take home point is that if you see a case of “pink eye/conjunctivitis” coming, call your eye doctor. If you are a contact lens wearer, it is very important to remove your contacts, and wear your glasses until you can be seen. Los Angeles residents can visit Melamed Eye Care, where most PPO health plans are accepted as well.

Does my health insurance cover vision? Does my vision insurance cover urgent eye visits? These are one of the many questions my staff and I get asked by patients. So here I am to clarify.

Vision insurances, such as Vision Service Plan (VSP), EyeMed, and Superior Vision are insurances usually granted by employers to employees for routine vision care. This includes comprehensive eye exams annually plus various coverage for frames, lenses, and contact lenses every 1-2  years.

What vision insurance generally does not cover are urgent eye visits or eye disease management such as swollen eyes, red eyes, dry eyes, glaucoma, eye infections, . . etc. These office visits would be covered by your medical health insurance (Anthem Blue Cross, Medicare, UnitedHealthcare, Blue Shield . .etc) if the doctor is a network provider for these health plans.

Dr. Fouad Melamed, is one of the few optometrist in Los Angeles, that is a network provider on most major medical health insurance plans PPO (and some minor ones too!). Your visit for urgent eye care needs will be billed to you health insurance plan and you would be responsible for the copay and deductable just like your other doctor’s visits.

So the next time you are having trouble with your eyes, understand that visits pertaining to the health of your eyes (not optically related), can be covered by your health insurance plan.

With the new Obama Health Insurance Law just passed, health insurance companies have been required in some cases to also provide routine vision care to their subscribers. If you have any questions regarding eligibility please send us an email or give us a call.

One of the latest advancements in contact lens technology is multifocal contact lenses. In the past, patients over the age of 40 had trouble with contact lens wear. Either reading glasses were needed to be worn over contacts, or monovision needed to be performed, where one eye is focused for distance, and other eye for near. Monovision, successful for some, has it drawbacks including reduced stereo vision.

The newest line of multifocal contacts including one of many fitted at our office, Acuvue Oasys for Presbyopia, allows patients over 40 to have simultaneous distance, intermediate, and close vision with BOTH eyes. This unique product has been very successful with patients and carries its unique brand of Acuvue Oasys, which is the leading contact lens in the market.

For patients with high astigmatism, in the past multifocal contacts were not an option. But advancements in lenses technology have produced lenses such as Coopervision’s Proclear Multifocal Toric, which can be fit with almost any amount of astigmatism. Proclears also ideal for patients with dry and irritated eyes.

Whether you have tried contacts in the past or curious to how it feels, Dr. Melamed and staff would love to give you a trial run, with no obligation to purchase boxes of contacts, on the newest contact lens design.