LACRIMAL TESTING - THE DYE DISAPPEARANCE TEST AND THE JONES TEST

This study assessed intraobserver and interobserver variability in the fluorescein dye disappearance test (DDT) and compared the DDT with a modified Jones I test in a masked clinical trial in asymptomatic patie nts. Seventy-six patients at the Jerry L. Pettis Memorial Veterans Adm inistration Hospital, (152 eyes) who were without epiphora, high tear lake, ectropion, or punctal stenosis in either eye underwent modified Jones testing and the DDT. The latter was photographed at 5 minutes, a nd the photos were assessed independently by three experts. Afterward, these experts assessed all the data as a group and made a final asses sment regarding patency. The final assessment of the panel was that 14 2 systems were patent, two were equivocal, and eight were obstructed. The DDT interpretations of two physicians were in agreement with the f inal assessment in 95% to 98% of eyes. The third physician had a syste matic error in his interpretation of the DDT, causing his results to b e only 73% accurate. Interobserver variability in the DDT was signific ant at P < 0.00005. The Jones test was in agreement with the final ass essment in 144 of 150 eyes, or 96%. When performed properly, the DDT a nd the Jones I tests gave excellent results in normal patients.