conjunctivochalasis

Conjunctivochalasis: A Common Eye Condition

Conjunctivochalasis, also known as CCH, is a relatively common ocular condition characterized by excess folds of conjunctival skin that accumulate between the globe and eyelids [1]. This condition can occur on both eyes and is often associated with aging.

Symptoms

In cases where the patient is symptomatic, common symptoms include:

• Tearing
• Foreign body sensation
• Ocular irritation
• Blurriness

These symptoms can range from mild discomfort to more severe ocular surface irritation [2].

Definition

Conjunctivochalasis is defined as a redundant, nonedematous conjunctiva that causes a wide variety of symptoms [9]. It is often described as lax and redundant folds of bulbar conjunctiva between the globe and eyelids [3][7].

Characteristics

This condition can be bilateral and is characterized by loose, redundant, and non-edematous conjunctival folds typically located in the inferior bulbar conjunctiva [12]. The term "chalasis" comes from the Greek meaning to slacken, which was first used by Hughes in 1942.

Diagnosis

Conjunctivochalasis can be difficult to diagnose and is often misdiagnosed as dry eyes or allergies. A slit-lamp examination is typically performed by an eye doctor to confirm the diagnosis [15].

References:

[1] - Conjunctivochalasis is a common eye condition often mistaken for dry eye. [2] - In cases where the patient is symptomatic, common symptoms include: tearing, foreign body sensation, ocular irritation, and blurriness, [3] - by P Chhadva · 2015 · Cited by 57 — Conjunctivochalasis (Cch) is described as lax and redundant folds of bulbar conjunctiva between the globe and eyelids. [7] - by P Chhadva · 2015 · Cited by 57 — Conjunctivochalasis (Cch) is described as lax and redundant folds of bulbar conjunctiva between the globe and eyelids. [9] - Oct 22, 2024 — Conjunctivochalasis is defined as a redundant, nonedematous conjunctiva that causes a wide variety of symptoms. [12] - Conjunctivochalasis (CCh) is an underdiagnosed and common condition characterized by loose, redundant, and non-edematous conjunctival folds typically located in the inferior bulbar conjunctiva. [15] - Conjunctivochalasis can be difficult to diagnose and is often misdiagnosed as dry eyes or allergies. If an eye doctor suspects CCh, they will likely perform a slit-lamp examination.

Common Signs and Symptoms of Conjunctivochalasis

Conjunctivochalasis, a common eye condition, can cause a range of symptoms that may vary in severity. Here are some of the most common signs and symptoms:

• Dry Eyes: One of the primary symptoms of conjunctivochalasis is dry eyes, which can be caused by the abnormal folds of conjunctiva blocking tear flow [4].
• Eye Irritation and Burning: Many people with conjunctivochalasis experience eye irritation and burning sensations due to the presence of redundant conjunctiva [8].
• Blurred Vision: Conjunctivochalasis can also cause blurred vision, which may be temporary or persistent depending on the severity of the condition [4].
• Watery Eyes: Some individuals with conjunctivochalasis may experience watery eyes due to an overproduction of tears in response to irritation [8].
• Ocular Discomfort: Patients with conjunctivochalasis often report chronic ocular discomfort, described as a sensation of grittiness or foreign body sensation [12].
• Localized Pain and/or Foreign Body Sensation: In some cases, the symptoms of conjunctival chalasis can be mistaken for dry eye, but the key difference is the presence of localized pain and/or foreign body sensation [11].

Early Stages

In its earliest stages, conjunctivochalasis may not be obvious to either the patient or the ophthalmologist. Some patients might be entirely symptomless, making it essential to take a brief history of symptoms during an eye exam [14].

Conjunctivochalasis, also known as loose or redundant conjunctiva, can be diagnosed through various tests and examinations.

• Slit-lamp examination: This is a common diagnostic tool used to examine the eyes and detect any abnormalities in the conjunctiva. A slit-lamp examination can help identify conjunctivochalasis by revealing the loose or redundant tissue (1).
• External examination: A doctor may perform an external examination of the eye to look for signs of conjunctivochalasis, such as a loose or hanging conjunctiva (4).
• Visual acuity assessment: This test measures the sharpness of vision and can help rule out other conditions that may be causing symptoms similar to conjunctivochalasis (6).
• Tear break-up time: This test measures the time it takes for tears to break up on the surface of the eye, which can be affected in cases of conjunctivochalasis (6).

It's worth noting that a diagnosis of conjunctivochalasis may also involve ruling out other conditions that can cause similar symptoms, such as dry eye syndrome or Sjögren's syndrome.

References: (1) [4] (4) [4] (6) [6]

Differential Diagnosis of Conjunctivochalasis

Conjunctivochalasis (CCH) is a condition characterized by loose, redundant, and non-edematous conjunctival folds typically located in the inferior bulbar conjunctiva. When diagnosing CCH, it's essential to consider other conditions that may present with similar symptoms.

Conditions to Rule Out:

• Dry eye syndrome: A common condition that can cause tear flow obstruction and tear film instability.
• Sjögren syndrome: An autoimmune disorder that affects the exocrine glands, including the lacrimal gland, leading to dry eyes.
• Meibomian gland dysfunction: A condition where the meibomian glands produce abnormal or inadequate tears, leading to dry eye symptoms.
• Blepharitis: An inflammation of the eyelids and conjunctiva that can cause redness, itching, and tearing.
• Allergic reactions: Allergies to pollen, dust, or other environmental factors can cause conjunctival irritation and tearing.

Other Conditions:

• Chemosis: A condition characterized by swelling of the conjunctiva and eyelids.
• Conjunctival infection or inflammation: Infections such as conjunctivitis or inflammation due to trauma or foreign bodies.
• Entropion: A condition where the eyelid rolls inward, causing irritation and tearing.
• Corneal dystrophies: Genetic conditions that affect the cornea, leading to vision problems.

Key Points:

• CCH should be considered in the differential diagnosis of chronic ocular irritation and epiphora (tearing).
• Dryness, eye pain, redness, blurry vision, and epiphora are common symptoms in patients with CCH.
• A complete ophthalmic examination is essential to rule out other conditions that may present with similar symptoms.

References:

• Meller D, Tseng SCG. Conjunctivochalasis: literature review and possible pathophysiology. Surv Ophthalmol. 1998;43:225-232.
• Other references in the context section provide additional information on CCH diagnosis and treatment.