Refers to redundant conjunctiva, most often evident between the globe and the lower eyelid, but in more advanced cases can be evident around the entire globe.
The majority of cases are bilateral.
Often considered a normal variant associated with the aging process if the patient is asymptomatic.
It may be symptomatic, with common symptoms of tearing, foreign body sensation, ocular irritation, and blurriness, especially in down gaze.
Redundant conjunctiva is typically first evident temporally.
In advanced cases conjunctiva may be redundant in 360 degrees.
Excessive movement of the conjunctiva occurs with blinking.
Abnormal dispersion of tear film occurs.
It is more common in patients who have dry eye and meibomian gland disease/blepharitis and is associated with contact lens wear.
Its etiology is not well understood: natural aging process, lid position abnormalities, ocular movements, ocular irritation, and eye rubbing are considerations.
Histologic findings include elastosis, non-granulomatous inflammation, elastic fiber fragmentation, and loss of collagen.
Matrix metalloproteinases (MMPs), (MMP-1 and MMP-3 enzymes) are enzymes that modify or degrade the extracellular matrix and are overexpressed in conjunctivochalasis fibroblasts.
It is hypothesized pressure from the eyelids may lead to impaired lymphatic drainage of the conjunctiva.
Conjunctivochalasis that is asymptomatic requires no treatment.
Medical treatment is recommended initially, for symptomatic patients, which includes: use of ocular lubricants, antihistamines and topical steroids.
If medical management is insufficient, surgical intervention may be necessary to resect the redundant conjunctival tissue.
Success rates in the improvement of symptom is found in about 88% of patients that undergo resection of symptomatic conjunctivochalasis.