If your eyes are constantly watering or feel irritated despite using eye drops, the problem may not be your eyes at all–it could be your tear ducts. A small but important part of your tear drainage system, the puncta (tiny openings at the corners of your eyelids) can become narrowed or blocked, leading to excessive tearing, discharge, or chronic irritation.
At her Irvine practice, Dr. Melanie Ho Erb offers Punctoplasty, a precise and minimally invasive tear duct repair surgery designed to restore proper tear flow. As a board-certified oculoplastic surgeon serving Orange County and Los Angeles, Dr. Erb specializes in treating delicate eyelid and tear drainage conditions with expert care.
Dr. Melanie Erb is a fantastic physician. Dr. Erb’s thoroughness is outstanding as she meticulously attended to every detail in my situation. I felt that she left no stone unturned in discovering the best plan of action that completely met my objectives. I trust Dr. Erb, and had an all-around positive experience. I will be referring friends and family to her.
What Is Punctoplasty?
Punctoplasty is a surgical procedure used to widen or reopen the puncta, the tiny drainage holes in the inner corners of your upper and lower eyelids. These openings are the entry points for tears to drain into the nasolacrimal system and eventually into the nose.
When the puncta become narrowed (punctal stenosis) or blocked due to age, chronic inflammation, medication side effects, or previous surgery, tears can’t drain properly. This leads to:
- Watery eyes (epiphora)
- Blurry vision due to tear buildup
- Irritation or a feeling of tearing all the time
- Mucous discharge or crusting in the corner of the eyes
Punctoplasty reopens the drainage system, allowing your tears to exit the way they’re supposed to.
When to Consider Punctoplasty
You may be a good candidate for this procedure if you experience:
- Constant tearing not caused by dry eyes or allergies
- Discomfort near the inner corner of the eyes
- A visible narrowing or closure of the punctal opening
- A history of punctal plugs, conjunctivitis, or eyelid inflammation
- Persistent tearing that hasn’t responded to eye drops or medical therapy
Dr. Erb will perform a comprehensive tear duct evaluation, which may include a dye test, irrigation, or probing, to determine if punctal stenosis is contributing to your symptoms.
How Punctoplasty Works
Punctoplasty is a quick and safe in-office procedure performed under local anesthesia. During the procedure, Dr. Erb:
- Makes a small, precise incision to widen the punctal opening
- May remove a small segment of tissue if the puncta are severely narrowed
- Ensures the new opening allows free tear drainage into the lacrimal system
The goal is to create a stable, long-term opening without scarring or future narrowing.
What to Expect After Punctoplasty
- Duration: Procedure typically takes under 20 minutes
- Anesthesia: Local numbing only–no sedation needed
- Recovery: Mild swelling or tearing for 1-3 days
- Results: Most patients experience a dramatic reduction in tearing within a week
- Follow-up: Dr. Erb may recommend tear duct flushing or a short-term stent for support
Frequently Asked Questions About Punctoplasty
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No. Dr. Erb uses a gentle local anesthetic. You may feel light pressure but not pain.
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Most patients do not experience dryness. Punctoplasty only improves drainage and does not affect tear production.
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While recurrence is rare, some cases may require re-treatment. Dr. Erb designs the repair to minimize this risk.
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In most cases, no stitches are required, and healing occurs naturally.
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Yes. Punctoplasty is typically covered as a medically necessary procedure. Our office will help verify your benefits and assist with authorizations.
Why Choose Dr. Melanie Ho Erb for Tear Duct Repair?
As a board-certified oculoplastic surgeon, Dr. Erb has extensive training in the anatomy and function of the eyelids and tear drainage system. She has successfully treated thousands of patients with tearing complaints and is known for:
- A gentle, conservative approach to tear duct surgery
- Natural-looking results with minimal downtime
- Personalized care–you’ll see Dr. Erb every step of the way
- Collaboration with your ophthalmologist or primary care provider if needed
With her unique blend of precision and compassion, Dr. Erb ensures that tear duct repair is as comfortable and effective as possible.
Meet Dr. ErbSchedule Minimally Invasive Tear Duct Surgery in Orange County
If chronic tearing is disrupting your day or making your eyes feel irritated and blurry, punctal stenosis may be the cause–and punctoplasty may be the solution. Dr. Melanie Ho Erb is a trusted provider of minimally invasive tear duct surgery in Irvine and the greater Los Angeles area.
Schedule your consultation today to restore tear drainage, comfort, and clarity.
Medically reviewed by Melanie Ho Erb, M.D. on