An ophthalmic insert and method for sustained release of medication to the eye are provided. The insert includes a body portion sized to pass through a lacrimal punctum and be positioned within a lacrimal canaliculus of the eyelid. The insert further includes a collarette connected to the body portion and sized to rest on the exterior of the lacrimal punctum, the collarette having a pore provided therein. A reservoir is contained at least partially within the body portion and in fluid communication with the pore, wherein the reservoir is designed to store and release medication through the pore and onto the eye over time in a controlled manner while the insert is positioned in the eyelid. Preferably, the pore is constructed with a specific geometry appropriate to control the rate of release of the medication onto the eye.