A modified Jones test: lacrimal scintigram correlation.

Abstract:

PURPOSE:To determine the correlation between lacrimal scintigraphy and a modified Jones primary dye drainage test combined with the fluorescein dye disappearance test (DDT) and Jones secondary dye test, in diagnosing the cause of epiphora. METHODS:A prospective, consecutive clinical trial was conducted. All patients presenting with epiphora were considered, but those with trichiasis, corneal irritation, lower eyelid ectropion, Bell palsy, or previous lacrimal surgery were excluded. A cohort of 39 patients (65 eyes) underwent the fluorescein DDT and the senior author's (R.B.) modified Jones primary dye drainage test (Jones dye test 1 [JDT1]). For this test, an entire fluorescein 2% Minim dose was instilled in the 2 eyes, and the patient was then asked to gently blow each nostril separately in a white tissue; the degree of fluorescein staining was noted. If there was no fluorescein staining of the tissue (negative JDT1), a traditional Jones secondary dye test (Jones dye test 2) was also performed. All patients except for those testing strongly positive on modified testing or with negative DDT and JDT1 and nil drainage from the nose in Jones dye test 2, indicating anatomical obstruction, were referred for lacrimal scintigraphy. RESULTS:In total, 59 of 65 eyes (91%) showed a positive correlation between the diagnosis arrived at after dye testing using the modified primary dye test and diagnosis on lacrimal scintigraphy. The interrater reliability for the raters was found to be κ = 0.770 and 95% confidence interval = 0.594-0.945. The strength of agreement is considered to be "good." CONCLUSIONS:The authors found that in the presence of patent lacrimal drainage system dysfunction, modified Jones primary dye test, combined with the fluorescein DDT and Jones secondary dye test, correlated strongly with lacrimal scintigraphy.

authors

Paramanathan N,Nemet A,Lee SE,Benger RS

doi

10.1097/IOP.0b013e3181c8ab70

subject

Has Abstract

pub_date

2011-03-01 00:00:00

pages

81-6

issue

2

eissn

0740-9303

issn

1537-2677

journal_volume

27

pub_type

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