Evaluation of the lacrimal drainage system

Methods of testing for lacrimal drainage insufficiency and a modification of the Jones fluorescein dye tests are presented. Despite their excellence, Jones tests have never been widely employed because of difficulty in dye retrieval. The modification consists of instilling one drop of the dye three times at 15 second intervals, and after a one minute period, placing the head down at a 45 degree angle for ten minutes. Anatomic and roentgenogram studies show that the dye can be easily lost posteriorly unless this is done. No nasal vasoconstrictors are used to avoid false negatives.