The Dry Eye Zone

Rebecca's Blog


Abstract: CPAP nasal pillow & Jones tubes

I think this case report might be about someone I once spoke with. The situation was that the CPAP device was blowing air so forcefully up the Jones tubes that it was pushing up her lids and affecting her eyes.

Since then I have spoken with a few people who either believed, or suspected, or from their description I myself suspected, were suffering from the same effect but without the Jones tubes. I posted about it once before in my newsletter hoping to drum up more information but no such luck. When I saw this case report I emailed the author asking if this was a credible explanation (i.e. that CPAP pressure could force air the wrong way through the canaliculus) and he felt it might given sufficient pressure to bypass the valves in the lacrimal system. Anyway, just putting this out there for what it's worth. There are so many people using CPAP these days, surely we'll here more in the next few years.

A 49-year-old woman, who had previously undergone bilateral Jones tube placement, began nasal continuous positive airway pressure for obstructive sleep apnea. The patient's use of continuous positive airway pressure was limited by intolerance of the transfer of air through the Jones tube to her ocular surface resulting in irritation and discomfort. A change from nasal continuous positive airway pressure to a full face mask, including both Jones tubes in the pressure circuit, resolved the problem.

Ophthal Plast Reconstr Surg. 2012 May 21. [Epub ahead of print]
Servat JJBlack EHGladstone GJ.
*William Beaumont Hospital, Department of Ophthalmology, Royal Oak, Michigan, U.S.A. †Kresge Eye Institute/Wayne State University, St. Antoine Detroit, Michigan, U.S.A.