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Are punctal plugs permanent?

Theoretically, yes, sort of.

Some plug designs are such that they can be removed relatively easily. Intracannicular plugs are much more difficult to get at and in fact it can be very difficult to figure out whether they are even there. Some plugs will fall out if not the right size.

But for the most part they work reasonably well. — If they work so well in the long term that you want to do something permanent, punctal cautery may be an option that you should discuss with your eye doctor.