Jones Lacrimal Bypass Tube
Some people have a severe blockage in the upper channels of the tear duct which causes severe watering (see WATERY EYES section) and cannot be treated with a traditional endoscopic or external dacryocystorhinostomy (DCR). Possible causes of such a problem include scarring secondary to infection, traumatic injuries or tumour removal from the inner corner of the eye and side effects of chemotherapy (usually for bowel cancer). In such circumstances it is not possible to insert the temporary soft silicone tube (which is usually removed after 6-8 weeks) commonly used in a standard DCR. (see TEAR DUCT SURGERY)
What is a Lester Jones Tube?
It is a small glass, or pyrex, bypass tube which is about 1.5cms long and a few mm wide. It is used to allow tears to drain from the inner corner of the eye into the nose. The tube is inserted, via a guide-wire track made through a bony opening into the nose, and sits in the inner corner of the eye. Generally it cannot be seen by others and remains in position indefinitely. An endoscope (small telescope) can be used to check that the tube is the correct size and is ideally positioned inside the nose. The operation is usually performed under general anaesthetic as a day-case.
The improvement in troublesome watering is usually significant, but the tube does require some maintenance to avoid blocking up with mucous. Other potential problems include infections and the tube becoming displaced eg: disappearing inwards into the nose. Some patients require more than one procedure before a stable functioning tube is achieved.