Conjunctivochalasis: a systematic review

Surv Ophthalmol. 2018 Jul-Aug;63(4):554-564. doi: 10.1016/j.survophthal.2017.10.010. Epub 2017 Nov 9.

Abstract

Conjunctivochalasis (CCH) is a conjunctival condition characterized by loose, redundant conjunctival folds, most typically in the inferior bulbar conjunctiva of both eyes. Although CCH is a common cause of ocular irritation and discomfort, especially in the elderly, it is often overlooked in clinical practice. CCH may be associated with various ocular and nonocular conditions; however, the most important risk factor is aging. Although often asymptomatic, CCH may cause symptoms related to tear film instability and/or delayed tear clearance. Pathogenesis of CCH remains largely unknown but may involve different elements such as aged conjunctiva, unstable tear film, mechanical friction, ocular surface inflammation, and delayed tear clearance. Contradictory results have been reported on histopathologic changes in CCH, with some studies showing a normal microscopic structure. For symptomatic CCH, medical treatment may include lubrication and anti-inflammatory medications. For symptomatic patients who fail to respond to medical treatment, a surgical procedure may be considered. Although various surgical procedures have been used for CCH, more often, it consists of conjunctival cauterization or excision of the redundant conjunctiva, with or without amniotic membrane transplantation.

Keywords: conjunctiva; conjunctivochalasis; delayed tear clearance; dry eye disease; ocular surface inflammation.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Aging / physiology*
  • Anti-Inflammatory Agents / therapeutic use
  • Conjunctival Diseases* / etiology
  • Conjunctival Diseases* / pathology
  • Conjunctival Diseases* / therapy
  • Dry Eye Syndromes / etiology
  • Dry Eye Syndromes / pathology
  • Humans
  • Lubricant Eye Drops / therapeutic use
  • Ophthalmologic Surgical Procedures / methods
  • Risk Factors
  • Tears / physiology*

Substances

  • Adrenal Cortex Hormones
  • Anti-Inflammatory Agents
  • Lubricant Eye Drops