Patient postoperative instructions sheet for Punctaplasty

 

VISIONARY EYE DOCTORS

Sandra Lora Cremers, MD, FACS

Johns Hopkins Medicine at Suburban Hospital

One Central Plaza  |  11300 Rockville Pike, Suite 1202, Rockville, MD 20852

Phone: 301-896-0890   |   Fax: 301-896-0968

 

POST-OPERATIVE INSTRUCTIONS

Punctoplasty (Punctal Opening Procedure)

You have just had a punctoplasty — a minor procedure to open the tiny tear drain (punctum) on your eyelid. This helps tears drain properly and reduces tearing or dry eye symptoms. Please follow the instructions below carefully for the best outcome.

 

💊  MEDICATIONS

Antibiotic + Steroid Eye Drop (NPD Drop) Neomycin-Polymyxin B-Dexamethasone (NPD) combination drop — prevents infection and reduces inflammation. Dose: 1 drop in the operated eye Frequency: 3 times per day (morning, midday, evening) Duration: 3 days ⚠  If you have a known allergy to neomycin, please call our office immediately.

 

 

🧊  COLD COMPRESSES — First 48 Hours

Start immediately after surgery and continue for the first 48 hours to reduce swelling and discomfort. •     Use a clean cloth or gauze dampened with cold water, or a gel ice pack wrapped in a cloth. •     closed eyelid only — do not press on the eye. •     10–15 minutes at a time, 3–4 times per day as needed. •     Never apply ice directly to the skin.

 

♨️  WARM COMPRESSES — Starting Day 3 (After 48 Hours)

After 48 hours, switch to warm compresses to promote healing and keep the punctum clear. •     comfortably warm water (not hot), or a Bruder warm compress mask. •     5–10 minutes, 2–4 times per day. •     1–2 weeks after surgery. •     After each session, gently clean the eyelid margin with a lid hygiene wipe or diluted baby shampoo.

 

 

🔍  WHAT TO EXPECT

Some mild swelling, redness, and tearing in the first 1–2 days is completely normal. You may notice:

•     A small amount of crusting at the inner corner of the eye — clean gently with a damp cotton pad.

•     Mild discomfort or a foreign body sensation at the eyelid margin.

•     Slightly increased tearing initially, which typically resolves as healing progresses.

•     A tiny scab at the punctal opening — do not pick or rub this.

 

 

DO'S & DON'TS

 

✅  DO	❌  AVOID
✔  Use your NPD drops as prescribed	✘  Rub or touch the operated eye
✔  Apply cold compresses for first 48 hours	✘  Swim or submerge your face for 2 weeks
✔  Switch to warm compresses after 48 hours	✘  Wear eye makeup for at least 1 week
✔  Keep eyelids clean and dry	✘  Use contact lenses until cleared
✔  Attend all follow-up appointments	✘  Do strenuous exercise for 48–72 hours

 

 

🚨  CALL OUR OFFICE IMMEDIATELY IF YOU EXPERIENCE:

•     Increasing pain, redness, or swelling after the first 48 hours •     Yellow or green discharge from the eye •     Fever over 101°F •     Sudden decrease in vision •     Any concern that does not feel right — we are always here to help   📞  Phone: 301-896-0890   |   Fax: 301-896-0968

 

 

📅  YOUR FOLLOW-UP APPOINTMENT

Your post-operative visit is typically scheduled 1–2 weeks after your procedure. At this visit, Dr. Cremers will examine the punctum, confirm it is healing and open properly, and discuss any additional treatment needed. Please keep this appointment even if you feel well.

 

With best personal regards,

Sandra Lora Cremers, MD, FACS

Johns Hopkins Medicine at Suburban Hospital  |  Visionary Eye Doctors

11300 Rockville Pike, Suite 1202, Rockville, MD 20852

Phone: 301-896-0890   |   Fax: 301-896-0968

This handout is for informational purposes only and does not replace individualized medical advice from your physician.