Have you ever observed a little hole close to your eyelids’ inner corner? Although you may have thought it was a tear or a speck, the punctum is a natural and significant part of your eye’s anatomy.
The punctum has an interesting job, despite its modest size. It is essential for maintaining the comfort, hydration, and health of your eyes.
In this blog, we’ll take a closer look at what the punctum is, what it does, and what happens when something goes wrong with it.
What Is the Punctum?
The punctum (plural: puncta) is a tiny hole on the edge of the upper and lower eyelids, closest to your nose and at the inner corner of your eye. Each person usually has four puncta: one on each of the upper and lower eyelids.
Despite their tiny size—typically little larger than a pinhead—the puncta are essential for the drainage of tears from your eyes.
What Does the Punctum Do?
Tears are necessary for healthy eyes. They maintain your eyesight, lubricate the surface, and guard against infections and dust. However, your tears require an exit when they have served their purpose. The puncta are used in this context.
This is how the method for draining tears operates:
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- The lacrimal glands above your eyes are responsible for producing tears.
- When you blink, they take up space on the surface of your eyes.
- Through the puncta, extra tears flow into small channels known as canaliculi.
- After that, the tears pass through the nasolacrimal duct, enter the lacrimal sac, and eventually exit the nose.
That’s why your nose runs when you cry—it’s your tear drainage system at work!
Is It Normal?
- Yes! It’s completely normal to have those little holes—they’re part of your anatomy.
You might notice them more if:
- You’re looking closely at a mirror
- You’re dealing with watery eyes or dry eye syndrome
Why Is the Punctum Important?
To keep the tear balance, a healthy punctum is important. Improper drainage of tears can result in:
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- Epiphora, or watery eyes: When your eyelids aren’t draining, tears overflow.
- Dry eyes: If drainage is excessively rapid or if therapy (such as punctal plugs) significantly obstructs it.
- Eye infections: Bacterial infections such as conjunctivitis or dacryocystitis can result from stagnant tears.
Because of its role in draining tears, the punctum is often involved in diagnosing and treating tear-related eye conditions.
Common Punctum-Related Conditions
Blocked Punctum / Tear Duct Obstruction
Watery eyes, hazy vision, or recurring infections can occasionally result from partial or complete blockage of the punctum or the ducts that attach to it.
Causes include:
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- Aging (ducts narrow over time)
- Inflammation
- Injury or trauma
- Congenital blockages (in newborns)
Treatment may include warm compresses, flushing the duct (irrigation), or minor surgical procedures like dacryocystorhinostomy (DCR).
Punctal Stenosis
This is when the punctum becomes narrowed, restricting tear drainage. It can be caused by:
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- Chronic inflammation
- Long-term use of certain eye drops
- Skin conditions (like eczema or rosacea)
Treatment may involve:
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- Punctal dilation (widening the hole)
- Surgery to open or reconstruct the drainage path
Punctal Plugs (for Dry Eyes)
Ironically, in order to help cure dry eyes, doctors occasionally purposefully block the punctum.
Tiny, biocompatible devices called punctal plugs are placed into the puncta to block the drainage of tears. More moisture is retained on the surface of the eye as a result.
They’re:
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- Often temporary and dissolvable
- Sometimes semi-permanent
- A common treatment for moderate to severe dry eye syndrome
When to See an Eye Doctor
If you notice any of the following symptoms, it’s a good idea to have your puncta (and tear system) checked:
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- Persistent watery eyes
- Frequent eye infections
- Dry, irritated, or gritty eyes
- Swelling or redness near the inner corners of your eyes
- Mucus discharge from the tear ducts
Your eye doctor may perform a simple test using dye or saline to check whether your tears are draining properly.
What About Tear Ducts in Babies?
It’s common for newborns to have blocked tear ducts, usually due to an underdeveloped drainage system. Most cases resolve on their own within the first year.
In the meantime, parents may be advised to:
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- Massage the area gently
- Keep their eyes clean
- Use prescribed antibiotic drops if infection occurs
If it doesn’t resolve naturally, a pediatric eye doctor may recommend a probing procedure to open the duct.
Caring for the Eye Area
To support healthy tear drainage and punctum function:
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- Avoid rubbing your eyes
- Remove makeup carefully and thoroughly
- Use eye-safe products
- Treat allergies or infections promptly
- Stay hydrated and practice good eyelid hygiene
Warm compresses and lid scrubs can help keep the eyelid margins clean—which is especially helpful if you have chronic dry eyes or blepharitis.
Conclusion
Despite being tiny, the punctum plays a crucial function in eye hydration, comfort, and tear outflow. You can keep your eyes healthier and more comfortable by knowing how this tiny hole functions and how to take care of it.
Don’t disregard the symptoms if you have dry, runny, or irritated eyes. Your punctum may be telling you something vital.
Schedule an appointment with our optometrist, Dr. Jeffrey Porter, and his associates.
Our experienced eye doctors in Crystal Lake and Algonquin, IL, are dedicated to providing exceptional eye checkups to residents of Crystal Lake, Algonquin, Illinois, and surrounding areas.
Walmart Vision Center Crystal Lake, IL
815-477-4053
Walmart Vision Center Algonquin, IL
847-458-5796
