A modified Jones test: lacrimal scintigram correlation

Area of Science:

• Ophthalmology
• Medical Diagnostics

Background:

• Epiphora, or excessive tearing, can significantly impact quality of life.
• Accurate diagnosis of the underlying cause of epiphora is crucial for effective treatment.

Purpose of the Study:

• To evaluate the correlation between lacrimal scintigraphy and a combination of modified Jones primary dye test, fluorescein dye disappearance test (DDT), and Jones secondary dye test.
• To assess the diagnostic accuracy of these dye tests in identifying the causes of epiphora.

Main Methods:

• A prospective clinical trial included 39 patients (65 eyes) presenting with epiphora, excluding those with specific contraindications.
• Patients underwent fluorescein DDT and a modified Jones primary dye test (JDT1).
• A Jones secondary dye test was performed if JDT1 was negative. Patients were referred for lacrimal scintigraphy unless anatomical obstruction was definitively identified.

Main Results:

• A strong positive correlation (91%) was observed between the diagnoses from the modified dye testing and lacrimal scintigraphy.
• The interrater reliability for the dye tests was found to be good (κ = 0.770).

Conclusions:

• The modified Jones primary dye test, in conjunction with fluorescein DDT and Jones secondary dye test, demonstrates strong correlation with lacrimal scintigraphy.
• This combination of dye tests is a reliable method for diagnosing lacrimal drainage system dysfunction causing epiphora.