Re: Punctal occlusion
Collagen plugs dissolve on their own, usually within a few days of insertion. They are a great way to determine whether you might be a good candidate for permanent punctal plugs.
Some patients will experience tear overflow (epiphora) with regular punctal plugs. If they go straight to silicone plugs, then depending what type they get it may be difficult to remove them. Collagen plugs will not necessarily prove whether silicone plugs will be helpful, but they can help gauge patients who will have overflow or who simply are very unlikely to benefit.
The main things to remember with punctal plugs are: (1) Many people can be helped by them but they are not appropriate for all situations; and (2) They are a tool, not a solution.
I cannot tell you any rules about plugs. Generally speaking, they "ought" to be most effective for people whose primary problem is an aqueous deficiency (i.e. people who test very low on Schirmerís). However, I know people who do not have an aqueous deficiency who benefited, and people who had a serious aqueous deficiency who not only did not benefit at all but found them absolutely intolerable. The only thing you can do is try.
I strongly suggest that anyone thinking of getting punctal plugs try the collagen plugs first.
Will your tears overflow? It's altogether possible. This is one of the reasons why it makes sense to try collagen plugs before permanent plugs.