I have found some relief with punctal plugs. I first tried them four years ago. A doctor placed some temporary ones and I felt they were just too confusing - were they working? Were they still in my eyes after a few weeks? I just didn't know.
So then I had a doctor place permanent plugs. It was a little bit uncomfortable at first and took about a week to get used to, but they helped. They were just one part of my treatment plan, however. I don't feel like they would have been enough on their own.
After a year, I lost one of the plugs while swimming. Three years in, I lost a different one - actually, I lost it twice. Not really sure what happened there. But I'm happy with them and I do think they help me not lose my tears so quickly. Plus, they have the benefit of not needing regular attention, unlike eye drops that I have to constantly put in or masks that have to be applied often.
Hope this helps! -Ava, chronicdryeye.net team