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What Is a Jensen Bypass (Lacrimal)?

A Jensen bypass is a tear drainage bypass procedure that routes tears into the nose when the normal tear channels are blocked. It is usually done with a small glass tube, often called a Lester Jones tube, placed from the inner corner of the eye into the nasal cavity. Eye doctors look at this option when the canaliculi are scarred, missing, or too damaged to carry tears. The main aim is to cut down constant tearing, irritation, and skin breakdown from overflow tears. Follow-up visits matter because the tube can collect mucus, shift position, or get blocked.

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What Is a Jensen Bypass (Lacrimal)?

A Jensen bypass is a tear drainage bypass procedure that routes tears into the nose when the normal tear channels are blocked. It is usually done with a small glass tube, often called a Lester Jones tube, placed from the inner corner of the eye into the nasal cavity. Eye doctors look at this option when the canaliculi are scarred, missing, or too damaged to carry tears. The main aim is to cut down constant tearing, irritation, and skin breakdown from overflow tears. Follow-up visits matter because the tube can collect mucus, shift position, or get blocked.

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What Problems Can Lead to a Lacrimal Bypass?

A lacrimal bypass is most often discussed after canalicular blockage, which can happen after facial trauma, burns, infections, or scarring from earlier surgery near the inner corner of the eye. Some people deal with long-term tearing because the drainage pathway is narrowed or fully closed, so tears spill onto the cheek instead of draining into the nose. Repeated swelling, crusting, or discharge around the tear drainage area can also point to a drainage problem that needs a closer look. During an exam, an eye doctor checks lid position, tear lake height, and how well tears drain with simple office tests. Imaging or irrigation can help confirm where the blockage sits before any surgical plan is made.

What Are Signs You Need a Tear Drainage Check?

Lots of tearing has many causes, so the pattern of symptoms can help guide the next step. If symptoms keep coming back, an eye exam can help sort out drainage issues from surface dryness or allergies.

  • Tears running down the cheek most days, even when you are not emotional
  • Sticky discharge, crusting, or recurrent ?goopy? inner-corner buildup
  • Swelling or tenderness near the inner corner of the eyelids
  • Blur that clears after wiping tears away
  • Skin irritation where tears sit on the cheek

How Is a Lacrimal Bypass Tube Placed?

Placement starts with mapping the blockage and confirming that a bypass makes sense for the tear pathway involved. The surgeon creates a small channel from the conjunctival side near the inner corner toward the nasal cavity, then fits a glass tube to match the length needed. The tube is positioned so tears can travel from the eye surface into the nose, where they can drain normally. Surgeons check tube position and airflow, then give aftercare steps to reduce infection risk and crust buildup. Follow-up visits focus on comfort, tube position, and whether the tube stays clear during day-to-day life.

How Do You Care for a Jones Tube After Surgery?

Most aftercare is about keeping the tube opening clear and reducing rubbing or pressure that can shift it. Many surgeons suggest gentle cleaning of crust at the inner corner, plus saline sprays or rinses for the nose if that matches the post-op plan. It also helps to avoid heavy nose blowing early on, since pressure changes can irritate the new tract. If tearing suddenly returns, the tube can be blocked by mucus, and the office can often clear it with a simple visit. Call the surgeon right away if there is severe pain, fast swelling, fever, or thick discharge, since those can point to infection.

Frequently Asked Questions About Jensen Bypass (Lacrimal)

Is A Jensen Bypass The Same As A Jones Tube Surgery?

Most people use ?lacrimal bypass? to describe surgery that uses a Lester Jones tube to reroute tears into the nose. The wording can vary by clinic, but the tube concept is the same. The procedure is usually discussed when the canaliculi cannot drain tears because of scarring or loss of tissue. An oculoplastic surgeon can explain which bypass method fits the specific blockage.

Can A Jones Tube Move Or Fall Out?

Yes, tube shift or extrusion can happen, especially with rubbing, trauma, or heavy crusting around the opening. If the tube moves, tearing can return or the inner corner can feel scratchy. A displaced tube needs an eye exam because early adjustment is often simpler than waiting. If the tube falls out, keep it clean if possible and contact the surgeon's office the same day.

How Long Does A Jones Tube Last?

A Jones tube can last for years, but it is not a set-and-forget device. Some people keep the same tube long-term with regular checkups and routine cleaning. Others need tube replacement because of blockage, poor positioning, or discomfort. Your follow-up schedule depends on symptoms, tube stability, and how easily the tube stays clear.

What Is The Difference Between DCR And A Jones Tube Bypass?

DCR, short for dacryocystorhinostomy, creates a new opening between the tear sac and the nose so tears can drain when the nasolacrimal duct is blocked. A Jones tube bypass, often done as conjunctivodacryocystorhinostomy, uses a small tube to route tears into the nose when the canaliculi are blocked or absent. Put simply, DCR works with the natural tear drainage entry path, while a Jones tube bypass creates an alternate route from the eye surface. The right choice depends on where the blockage sits and how healthy the canaliculi are.

References

1. Conjunctivodacryocystorhinostomy. EyeWiki. https://eyewiki.org/Conjunctivodacryocystorhinostomy. Accessed February 5, 2026.

2. Conjunctivodacryocystorhinostomy With Lester Jones Tube. EyeWiki. https://eyewiki.org/Conjunctivodacryocystorhinostorhinostomy_with_Lester_Jones_Tube. Accessed February 5, 2026.

3. Canalicular Obstruction. EyeWiki. https://eyewiki.org/Canalicular_Obstruction. Accessed February 5, 2026.

4. Dacryocystorhinostomy. EyeWiki. https://eyewiki.org/Dacryocystorhinostomy. Accessed February 5, 2026.

5. Conjunctivodacryocystorhinostomy in the Treatment of Canalicular Obstruction. National Library of Medicine. https://pubmed.ncbi.nlm.nih.gov/15031180/. Accessed February 5, 2026.