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Evaluating the Endoscopic Jones Primary Dye Test in Lacrimal Dysfunction.

Carmelo Z Macri1,2, Jessica Y Tong1,2, Abdullah I Almater3,4

  • 1The Discipline of Ophthalmology and Visual Sciences, The University of Adelaide, Adelaide, SA, Australia.

Seminars in Ophthalmology
|November 17, 2025
PubMed
Summary

The endoscopic Jones (eJones) I test accurately identified anatomical obstruction in epiphora patients but showed variable results for functional epiphora. Further research is needed to refine its diagnostic use.

Keywords:
Functional EpiphoraJones Testnasoendoscopynasolacrimal duct obstructionnasolacrimal duct stenosis

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Area of Science:

  • Ophthalmology
  • Oculoplastics
  • Diagnostic Imaging

Background:

  • Epiphora, or excessive tearing, can significantly impact quality of life.
  • Accurate diagnosis of epiphora is crucial for effective treatment.
  • The endoscopic Jones (eJones) tests are used to evaluate lacrimal drainage function.

Purpose of the Study:

  • To assess the diagnostic accuracy of the eJones I and II tests.
  • To compare eJones test results with imaging findings in epiphora patients.

Main Methods:

  • Retrospective review of 35 eyes presenting with epiphora.
  • Patients underwent rigid nasal endoscopy, dacryocystography (DCG), and dacryoscintigraphy (DSG).
  • Lacrimal drainage was categorized as nasolacrimal duct obstruction (NLDO), stenosis (NLDS), or functional epiphora.

Main Results:

  • eJones I test was negative in all cases of NLDO or NLDS (n=14).
  • eJones I test was positive in all cases with normal imaging (n=4).
  • Functional epiphora (n=17) showed mixed eJones I test results.

Conclusions:

  • The eJones I test effectively identifies anatomical obstruction.
  • Diagnostic utility of eJones I is limited in functional epiphora due to its multifactorial nature.
  • Further validation studies are recommended for eJones testing in epiphora diagnosis.