The Jones dye test (primary Jones test) is positive when fluorescein dye instilled in the conjunctival sac appears at the inferior meatus within 5 minutes. A negative primary Jones test with a positive secondary Jones test indicates:

• A Functional epiphora (lacrimal pump failure) with a patent but incompetent lacrimal drainage system ✓
• B Complete nasolacrimal duct obstruction
• C Punctal stenosis as the primary cause
• D Canalicular block proximal to the lacrimal sac

Explanation

In the Jones dye test: Primary Jones test (PJT) positive = physiological drainage is intact (pump + anatomy). If PJT is negative (no dye at inferior meatus in 5 min), the secondary Jones test (SJT) is performed — the nose is irrigated with saline after applying dye, and the lavage is examined. A negative PJT but positive SJT means dye did enter the sac (anatomy patent) but failed to traverse to nose under physiological conditions = functional epiphora / lacrimal pump failure (e.g., from lower lid laxity, orbicularis weakness). A negative SJT indicates anatomical obstruction below the sac.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.