Complications of malpositioned Jones tubes.

A Jones tube is an effective lacrimal drainage bypass device often associated with post-operative problems. Unsuspected migration of the tube may cause signs and symptoms that are not immediately identified with the prosthesis. Malposition of Jones tubes in three patients resulted in the following complications. The first patient had persistent episcleritis and atypical facial pain and numbness caused by migration of the tube against the globe and into the nasal septum. Bilateral tubes in the second patient were improperly oriented, causing severe scleral erosion and ulceration. The third patient's bilateral tubes migrated through the conjunctiva into the subcutaneous tissues and were manifested as lower eyelid inflammatory masses. Placement of a Jones tube requires long-term maintenance by the physician and the patient.