Hi. I'm online and happy to answer your question today.
I see that you are offline. I'll switch over to the Q&A system. This system works a lot like 'text messaging' but an email is sent to each of us anytime something is posted to this thread. We can continue to work on your question there..... :)
temporary punctal occlusion of the lower puncta, then, if needed, temporary occlusion of all 4 puncta....
I don't understand what this means?