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Lacrimal testing. Age as a factor in Jones testing

J E Hagele1, J P Guzek, G W Shavlik

  • 1Department of Ophthalmology, Veterans Administration Medical Center, Loma Linda, California 92357.

Ophthalmology
|March 1, 1994
PubMed
Summary

Lacrimal transit time significantly slows with age, with a modified Jones test showing longer dye passage in individuals over 45. This age-related change impacts lacrimal system assessment.

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Area of Science:

  • Ophthalmology
  • Oculoplastics
  • Tear Drainage Physiology

Background:

  • Lacrimal transit time (LTT) is a key indicator of tear drainage efficiency.
  • Age-related physiological changes can affect the lacrimal system's function.
  • Understanding normative LTT across age groups is crucial for diagnosing epiphora.

Purpose of the Study:

  • To determine if lacrimal transit time (LTT) varies significantly with age.
  • To establish age-specific reference values for LTT using a modified Jones test.
  • To differentiate normal age-related LTT changes from pathological nasolacrimal duct obstruction.

Main Methods:

  • A modified Jones test was administered to 101 control subjects and 18 patients with suspected lacrimal abnormalities.
  • 2% sodium fluorescein dye was instilled into the right eyes, with dye passage assessed in the nose every 3 minutes for 24 minutes.
  • Subjects were stratified into age groups (under 45 and 45 and older) for analysis.

Main Results:

  • A statistically significant difference (P = 0.0091) in LTT was observed between age groups.
  • Control subjects under 45 years had a median LTT of 3 minutes (91% passed dye ≤ 6 minutes).
  • Control subjects 45 years and older had a median LTT of 6 minutes (84% passed dye ≤ 12 minutes).
  • Patients with nasolacrimal duct obstruction exhibited significantly prolonged LTT.

Conclusions:

  • Lacrimal transit time demonstrably slows with advancing age.
  • The modified Jones test provides age-adjusted cutoffs: ≤ 6 minutes for those under 45, and ≤ 12 minutes for those 45 and older.
  • These age-specific criteria aid in the diagnosis of lacrimal drainage disorders.

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