Which statement about Jones 1 versus Jones 2 testing is NOT true?

• A. A positive Jones 1 test represents a patent drainage system
• B. A Jones 2 test is performed after a negative Jones 1 test
• C. Reflex of fluid through the opposite canaliculus and puncta is a sign of an upper or lower canaliculus blockage
• D. It is a positive Jones 2 test if the patient tastes saline

Answer: (D)

Jones tests check how well tears drain through the nasolacrimal system. In Jones I you place fluorescein in the eye and see if it shows up in the nasal discharge; if it does, the system from the puncta to the nose is patent. If it doesn’t, you proceed to Jones II, where you push dye through the nose toward the tear drainage path and look for its return into the conjunctival sac; this helps localize where a blockage lies. A reflex of fluid through the opposite canaliculus and puncta indicates a blockage in the canaliculus on the tested side. A positive Jones II result is not determined by the patient tasting saline; instead, it’s identified by fluorescein appearing in the conjunctival sac after nasal irrigation. So the statement about tasting saline is not true.