Conjunctivochalasis

Abstract

Conjunctivochalasis is an ocular condition characterized by loose, redundant, nonedematous conjunctiva. Although the prevalence of conjunctivochalsis in Thailand remains unknown, it has been documented that conjunctivochalsis increases in incidence and severity with age. This condition has also been found more frequently in patients with thyroid disease, dry eye, anterior blepharitis, meibomian gland dysfunction (MGD), and contact lens wear. Conjunctivochalasis usually occurs bilaterally, but it is often overlooked because the majority of cases are asymptomatic. As the disease progresses, a patient can become symptomatic. Common symptoms include ocular irritation, foreign body sensation, discomfort, dryness, and tearing. These symptoms are non-specific and similar to those of other more common ocular surface diseases such as dry eye disease which could be found concomitantly. The diagnosis of conjunctivochalsis is simply made by increasing awareness of its existence and thorough slit-lamp examination of the ocular surface, particularly in patients presented with chronic ocular surface disorders and poorly responded to medications. No treatment is necessary if the patient is asymptomatic. Once the patient develops significant symptoms, medical therapy is initiated with ocular lubricants, topical antihistamines, or topical steroids. Other components of concomitant ocular surface diseases, including allergic conjunctivitis, dry eye disease, and MGD should be concurrently managed. In cases where medical treatments fail to control the patient’s symptoms, surgical intervention is indicated. Conjunctivochalasis surgery is safe and effective and has an excellent prognosis. The surgery can help reduce or eliminate the symptoms over the long-term.