Five patients in this study presented with epiphora. In all five patients, CChs were located at the nasal side, and all patients had open lacrimal passage. [dovepress.com]

Bilateral presentation is most common, but it may also be asymmetrical and even unilateral. [reviewofophthalmology.com]

Pearls and Other Issues To look for the LIPCOF and examine the fornices in all patients presenting with ocular irritation or epiphora. Fornix reconstruction is the key to surgical success. [ncbi.nlm.nih.gov]

• Dry Eyes

  Mechanical dry eye should not be confused with aqueous tear deficiency dry eye or delayed tear clearance.[5] Mechanical dry eye patients complain of blurry vision and pain that tend to be worse when looking down such as while reading. [en.wikipedia.org]

  Some patients have been treated for dry eye with limited improvement. [eyewiki.aao.org]

  In contrast, patients with dry eyes have worsening symptoms when looking up (e.g., at a computer), as the interpalpebral exposure zone widens and also improves with increased blinking. [ncbi.nlm.nih.gov]

  In these cases, it’s not unusual for mild conjunctivochalasis to be misidentified as a normal variant of dry eye and a result of the aging process. [reviewofophthalmology.com]

  Conjunctivochalasis has been strongly correlated with aging and concomitant dry eye disease. The currently recognised pathophysiology is associated with mechanical friction, tear film instability… References SHOWING 1-10 OF 54 REFERENCES [semanticscholar.org]

• Foreign Body Sensation

  Diagnosis Clinical History Patients often describe insidious onset of ocular discomfort, foreign body sensation, dryness, and tearing. Some patients have been treated for dry eye with limited improvement. [eyewiki.aao.org]

  Symptoms often include mild irritation, foreign body sensation, localized pain, tearing, blurred vision, burning, mucus discharge and nocturnal lagophthalmos. [reviewofophthalmology.com]

  body sensation, subconjunctival hemorrhage and ulceration. [en.wikipedia.org]

  Symptoms can be vague and comprise foreign body sensation, burning, pain, redness, epiphora, photophobia, and blurry vision, typically worsened during downgaze, blinking, or digital compression onto the globe.[19][20] It is thought that patients with [ncbi.nlm.nih.gov]

  body sensation, redness, subconjunctival hemorrhage, eye pain, and blurriness, especially in downgaze. [dovepress.com]

• Irritability

  Symptoms often include mild irritation, foreign body sensation, localized pain, tearing, blurred vision, burning, mucus discharge and nocturnal lagophthalmos. [reviewofophthalmology.com]

  […] known as Mechanical Dry Eye (MDE), is a common eye surface condition characterized by the presence of excess folds of the conjunctiva located between the globe of the eye and the eyelid margin.[1] Symptoms[edit] Symptoms range from dry eye, epiphora and irritation [en.wikipedia.org]

  Eye rubbing from irritation or allergy may also contribute to this laxity. [dovepress.com]

  However, CCH can be a possible origin of ocular surface irritation and tearing. When severe, CCH can also lead to blurred vision, mucous discharge, dryness, ocular fatigue, and subconjunctival hemorrhage. [eyewiki.aao.org]

  Pearls and Other Issues To look for the LIPCOF and examine the fornices in all patients presenting with ocular irritation or epiphora. Fornix reconstruction is the key to surgical success. [ncbi.nlm.nih.gov]

Asymptomatic patients don’t require treatment. For symptomatic patients, conservative treatment is initially targeted at lubrication of the ocular surface. [reviewofophthalmology.com]

No treatment is needed if the patient is asymptomatic. Medical therapy Mild symptoms can be addressed with topical lubrication, blinking exercises, topical antihistamines, and topical corticosteroids. [eyewiki.aao.org]

Treatment[edit] Mild Conjunctivochalasis can be asymptomatic and in such cases does not require treatment. [en.wikipedia.org]

no treatment is necessary. [ncbi.nlm.nih.gov]

Novel use of fibrin glue in the treatment of conjunctivochalasis. Cornea. 2008;27:950–952. [dovepress.com]

Prognosis Prognosis is good with proper diagnosis and treatment. References ↑ Marmalidou A, Kheirkhah A, Dana R. Conjunctivochalasis: a systematic review. Surv Ophthalmol 2018;63:554-564. ↑ Chan DG, Francis IC, Filipic M, Coroneo MT, Yong J. [eyewiki.aao.org]

Prognosis CCh typically has a good prognosis with the correct treatment. Diagnosis is, however, often missed or delayed. Surgical management may be needed in symptomatic patients who do not respond to initial medical treatment. [ncbi.nlm.nih.gov]

Disease Entity Conjunctivochalasis (CCH) Disease Conjunctivochalasis Etiology Etiology is uncertain but is likely associated with age or eye rubbing (i.e. allergic conjunctivitis). [eyewiki.aao.org]

[…] of CCh have been published,2–4 but the exact etiology is still not well understood. [dovepress.com]

CCh can cause a spectrum of symptoms, ranging from mild discomfort in the mild stages to tear outflow obstruction in the moderate stages and exposure keratopathy with subsequent visual loss in the severe stages.[1] Etiology The etiology of CCh has not [ncbi.nlm.nih.gov]

Epidemiology CCh generally affects the older population and is therefore often regarded as a senile change. [ncbi.nlm.nih.gov]

Assessing the severity of conjunctivochalasis in a senile population: a community-based epidemiology study in Shanghai, China. BMC Public Health. 2011;11:198. 30. Mimura T, Yamagami S, Usui T, et al. [dovepress.com]

The currently recognised pathophysiology is associated with mechanical friction, tear film instability… References SHOWING 1-10 OF 54 REFERENCES [semanticscholar.org]

Ocular inflammation plays an important role in the pathophysiology of CCh. [ncbi.nlm.nih.gov]

Risk Factors Risk factors for CCH include age, eye rubbing, ocular surface disease, allergic conjunctivitis, dry eye, contact lens wear, hyperopia, pinguecula, UV exposure, eyelid disorders, and thyroid disease. [1] General Pathology Pathophysiology The [eyewiki.aao.org]

"Conjunctivochalasis: literature review and possible pathophysiology". Survey of Ophthalmology. 43 (3): 225–32. doi:10.1016/s0039-6257(98)00037-x. PMID 9862310. ^ Bosniak, Stephen L. (1988). [en.wikipedia.org]

Conjunctivochalasis: Literature review and possible pathophysiology. Survey of Ophthalmology 1998;43:3:225-232. 6. Marmalidou A, Kheirkhah A, Dana R. Conjunctivochalasis: A systematic review. Survey of Ophthalmology 2018;3:554-564. 7. [reviewofophthalmology.com]

Primary prevention Patients may avoid eye rubbing and UV exposure and can treat any underlying ocular surface issues. CCH occurs largely secondary to age, however, so preventative strategies are limited. [eyewiki.aao.org]

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