Dry Eye

Experience lasting dry eye relief with compassionate care at Vantage’s clinics in Monterey, Salinas, and Ryan Ranch, CA.

Dry Eye (Ocular Surface Disease)

Ocular surface disease is commonly referred to as “dry eye.” It is a prevalent ocular condition that affects anyone, but its prevalence increases with age, and it is more common among women. Dry, irritated eyes can make every day a struggle. If you suffer from chronic dry eye or dry eye syndrome, you know the stinging, burning, gritty sensation that never seems to go away. Your eyes may water excessively (ironically, a sign of dryness), appear red, or feel tired and blurry by afternoon. It’s frustrating and uncomfortable, impacting everything from reading to driving at night. Many in Monterey and Salinas experience these dry eye symptoms, and Vantage dry eye optometrists are here to help. We take a personalized approach to dry eye treatment, focusing on accurate diagnosis and effective relief so you can reclaim comfortable, clear vision.

Middle-aged man applying eye drops for dry eye relief while standing near a window in soft natural light.
Close-up photo of a Schirmer’s tear test strip placed in the lower eyelid to measure tear production during a dry eye evaluation.

How We Diagnose

At Vantage, our dry eye specialists understand how dry eye disease affects your quality of life. We’ve built our dry eye treatment services around two proven solutions: the Schirmer’s tear test for precise diagnosis, and punctal plugs for long-lasting relief. By combining thorough testing with advanced therapy, we create a customized plan to treat dry eyes and provide the relief you’ve been searching for. Whether you’re in the heart of Monterey, neighboring Salinas, or the Ryan Ranch area of Monterey County, our team is ready to help you find real, lasting dry eye relief.

Schirmer’s Test: Pinpointing the Cause of Dry Eyes

Schirmer’s test (also known as the Schirmer tear test) is a simple in-office test used to measure tear production. This diagnostic test helps us understand whether your eyes produce enough tears to keep them moist. By identifying the severity of your tear deficiency, we can tailor a treatment plan that effectively addresses your specific needs.

What Is the Schirmer Tear Test?

The Schirmer test is a tried-and-true method for diagnosing dry eye syndrome. It involves using a thin strip of special filter paper (sometimes called a Schirmer strip) placed gently under your lower eyelid to collect tears. You will sit comfortably with eyes closed for about five minutes as the paper absorbs your tears. After that, we remove the strip and measure the amount of moisture on it. The wetter the strip, the more tears you produce. If only a small portion of the strip is moist, it indicates low tear production (in fact, less than about 5 milliliters of moisture after 5 minutes suggests severe dry eye).On the other hand, a typical result would show adequate tear wetting, meaning your eyes are producing sufficient tears.

How Schirmer’s Test Feels and Why We Use It

Patients often ask if the Schirmer test is uncomfortable. It’s a quick and painless test. You might feel a slight tickle or awareness of the paper strip, but there’s no significant pain. If needed, our eye doctor can even use a numbing drop beforehand so you stay completely comfortable. The test does not involve any needles or machines; it simply requires a small paper strip and a few minutes of your time.

We perform the Schirmer tear test because it gives us an objective measure of your tear production. Dry eye can have many causes (from aging and screen use to autoimmune conditions like Sjögren’s syndrome), so it’s essential to confirm that inadequate tears are part of the problem. This test, along with a thorough eye examination, enables us to diagnose dry eye with confidence. With the results in hand, we can discuss whether you genuinely have dry eye disease (and how severe it is) or if something else might be causing your symptoms. Most importantly, knowing your Schirmer test results helps us determine the best course of action, including whether you’re a good candidate for treatments like punctal plugs.

Your eye doctor will explain your results clearly and thoroughly. For example, if your tears only wet 5 mm of the strip, we know your eyes aren’t producing enough moisture, and we’ll need an aggressive plan to get you relief. If your result is closer to normal, we might investigate other causes or focus on improving tear quality.

By starting with a Schirmer’s test at our Monterey, Salinas, or Ryan Ranch office, we eliminate the guesswork in diagnosing dry eye. It’s one of the first steps toward lasting comfort.

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Punctal Plugs: Lasting Relief for Dry Eye Patients

Vantage offers punctal plugs to give you long-lasting dry eye relief. Punctal plugs (sometimes called tear duct plugs or lacrimal plugs) are tiny biocompatible devices that we insert into your tear drainage ducts (called puncta) to retain your natural tears. By blocking the tear ducts, punctal plugs slow or stop tear drainage, helping your eyes stay moist instead of drying out. By offering punctal plugs at our Monterey, Salinas, and Ryan Ranch, CA locations, Vantage provides a state-of-the-art solution to help you finally experience life without chronic dry eye holding you back.

Close-up landscape photo of a fingertip holding a tiny clear punctal plug used in dry eye treatment.

Types of Punctal Plugs We Offer (Temporary vs. Permanent)

We will choose the type of punctal plug based on your specific condition. Some patients start with a temporary plug in each eye and later receive silicone plugs for lasting therapy. Others with severe, chronic dry eye may opt for the longer-term plugs to achieve maximum relief right away. Our goal is to keep your eyes comfortably moisturized all day.

These plugs are made of a material like collagen that naturally dissolves over time (usually in a few days up to a couple of months). Temporary collagen plugs are a great trial solution – they allow us to see how much relief you get when your tear ducts are blocked. If your dry eye symptoms improve significantly with a dissolvable plug, that’s a good sign you’ll benefit from a longer-lasting solution. These plugs eventually dissolve on their own, making them ideal for providing relief for a specific period or for those recovering from surgery/illness that causes dry eye.

For more persistent dry eye relief, we use medical-grade silicone punctal plugs. Silicone plugs do not dissolve; they can stay in place for years, continuously blocking tear drainage. Don’t worry, “permanent” doesn’t mean we can’t remove them. It simply means the plug won’t break down over time. If needed, our doctors can easily remove or replace a silicone plug (for example, if your eyes start tearing excessively or if the plug ever irritates you, which is uncommon). We typically move to permanent punctal plugs after confirming that blocking the tear ducts helps your condition (often by trying a temporary plug first). Many patients enjoy long-term comfort with silicone plugs in place.

What to Expect During Punctal Plug Placement

1

Quick Examination

Your provider will examine your tear ducts to determine the correct plug size and placement.

2

Gentle Numbing

A numbing eye drop may be applied to prevent irritation and keep you comfortable during the procedure.

3

Plug Placement

Using a gentle applicator, your doctor places the tiny punctal plug into the opening. The process usually takes just a minute or two per eye.

4

Minimal Sensation

You may feel slight pressure, but most patients say it’s easier than inserting a contact lens.

5

No Downtime

There’s no recovery period! You can return to work or daily activities immediately after your appointment.

6

Customized Placement

In most cases, plugs are placed in the lower eyelids first, where most tear drainage occurs. If needed, plugs can also be placed in the upper ducts for additional tear preservation.

Benefits of Punctal Plugs for Dry Eye

Punctal plugs have been a game-changer for many dry eye patients in the Monterey and Salinas area. Here are some of the benefits you can expect:

1

Significant Dry Eye Relief

By increasing your eye’s tear retention, plugs help relieve the gritty, burning sensations of dryness. Patients often report less redness, less irritation, and more comfortable eyes even at the end of the day.

2

Better Vision Quality

When your eyes are well-lubricated, your vision stays clearer and more stable. Reducing dry spots on the eye can help minimize the frustrating fluctuations in vision associated with dry eye. Reading, computer work, and night driving can all become easier.

3

Reduced Dependence on Eye Drops

Tired of constantly putting in artificial tears? After punctal plug insertion, you may find you don’t need drops as frequently because your natural tears aren’t draining away. The moisture your eyes desperately need is conserved, providing a more natural relief.

4

Quick, Safe, and Reversible Treatment

Inserting punctal plugs is one of the simplest procedures we do – it’s done right in our office, with no surgery needed. If, for any reason, you need a plug removed (for instance, if your eyes become too watery or you’re getting other treatment), we can quickly remove or replace it. You’re in control of your comfort.

5

Long-Term Solution

Unlike temporary fixes that only last an hour or two, punctal plugs address the root problem of tear loss.

Commonly Asked Questions

Punctal plugs are tiny (about the size of a grain of rice or even smaller) and sit in the tear duct opening, not on the surface of your eye. You should not feel the plugs once they’re inserted. Most patients say they forget they even have plugs. If you do feel any discomfort afterward, we’d have you come in to check the fit, but that’s uncommon. Overall, punctal plugs are designed to be comfortable while they do their job of keeping your eyes moist.

It depends on the type of plug. Temporary punctal plugs made of collagen will dissolve on their own. They can last anywhere from a few days to a few months (often around 1–3 months) before they fully dissolve. Permanent (silicone) punctal plugs, on the other hand, can last indefinitely – essentially as long as you need them. They won’t dissolve at all. However, “permanent” means long-term; these plugs can be removed by the doctor at any time. In fact, some patients use silicone plugs for several years and later have them removed if their condition improves or if they undergo another treatment. We will guide you on which type is appropriate. Many patients begin with a dissolving plug and, if it is helpful, transition to a longer-lasting silicone plug for added convenience.

Many patients find they use artificial tears less often once their punctal plugs are in place. Since the plugs help your natural tears stay longer on your eyes, you may notice you’re not reaching for your eyedrops every hour like before. However, punctal plugs aren’t a total replacement for all other dry eye remedies. You might still use lubricating drops occasionally for example, first thing in the morning or during a windy day but likely with much less frequency. If you’re using medicated drops (such as for inflammation), you may continue them as directed by your doctor, as plugs work in tandem with other treatments by keeping these medications on your eye surface longer. Overall, plugs should significantly reduce your dependence on over-the-counter tears and keep your eyes feeling comfortable for more extended periods of time.

Dry eye is usually a chronic condition, not something that can be permanently cured. However, with the proper diagnosis and targeted treatments, dry eye symptoms can be well-controlled. Many patients experience lasting comfort and clearer vision with a personalized treatment plan designed to keep the eyes properly lubricated and protected.