The Jones tube is a small, glass bypass device used to manage persistent excessive tearing (epiphora) when initial tear duct surgery has not fully resolved the issue. The device is typically placed in the inner corner of the eye, extending into the nasal cavity, creating a permanent channel for tear drainage. Consistent and proper maintenance is necessary to ensure the tube remains functional, clear, and correctly positioned. Successful long-term drainage relies heavily on the patient’s commitment to a specific care regimen to prevent complications like blockage or displacement.
Essential Daily Care Routine
A routine of preventative measures is the foundation of Jones tube maintenance, aiming to keep the tear drainage path clear and the surrounding area hygienic. The primary daily activity involves a technique called “snuffing.” The patient introduces a few drops of an approved solution, such as artificial tears or saline, into the eye and then gently inhales through the nose while closing the opposite nostril. This action draws the liquid through the tube and into the nose, helping to flush out any accumulating debris or mucus. This procedure should be performed multiple times throughout the day, as directed by the eye care professional, to maintain patency.
Beyond internal flushing, external hygiene of the tube’s opening, or flange, is also important. The area around the tube should be gently cleaned using a soft cotton swab soaked in a prescribed cleaning solution. This wiping removes any crusting or dried secretions that could otherwise fall into the tube or irritate the delicate tissue around the eye. Patients should visually check the tube’s position in a mirror every morning to ensure the flange is resting correctly in the inner corner of the eye.
A precautionary measure to prevent accidental movement is to place two fingers over the tube’s opening when performing actions that increase nasal pressure, such as sneezing or blowing the nose. This physical barrier helps stabilize the tube and protects it from being forcefully dislodged. Regular check-ups with the surgeon, typically every six to twelve months, are a necessary part of the long-term care plan, allowing for professional inspection and cleaning of the tube.
Addressing Common Clogging Issues
Even with diligent daily care, blockages can occur, often signaled by an increase in tearing. When the tube feels sluggish, the first step is to intensify the routine flushing technique using the prescribed artificial tears or saline solution. The patient should apply the drops and perform the sniffing action more frequently than the standard daily routine to dislodge the obstruction.
If the tube remains blocked or resistant to flushing, the ophthalmologist may recommend a more directed irrigation technique. This typically involves using a small syringe to gently inject a sterile solution directly into the tube’s opening to apply steady, controlled pressure to the clog. Force should never be used, as excessive pressure can potentially damage the tube or the surrounding tissue. If home management techniques fail to restore proper drainage, it indicates a stubborn blockage, perhaps from a mucus plug or tissue overgrowth, which requires an in-office procedure. During a professional visit, the tube may be cleaned in situ using a micro-brush or, in some cases, temporarily removed, cleaned, and immediately replaced by the surgeon.
Recognizing Tube Displacement and Infection
Tube displacement or infection requires immediate professional medical attention. Tube displacement occurs when the glass device moves from its intended position, which can manifest as the tube sticking out further than usual, having excessive movement, or even falling out completely. Since migration is the most common reason for Jones tube removal, patients must check the tube’s position daily.
Signs of infection include localized redness, swelling, and pain around the insertion site, which may be accompanied by a yellowish or greenish discharge. A fever or general malaise are also indications of infection. If displacement or infection is suspected, the patient must immediately contact their surgeon or clinic. Avoid attempting to push a displaced tube back into place or remove it entirely, as this can cause further injury or complicate later medical intervention.