Conjunctivochalasis Displacing Tears

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Conjunctivochalasis Displacing Tears

Shown here is a segment of video showing conjunctivochalasis. Conjunctivochalasis (CC) as described by EyeWiki is “redundant, nonedematous conjunctiva that causes a wide variety of symptoms ranging from completely asymptomatic, to worsening of an unstable tear film, and when severe, a real mechanical disruption of tear flow.”  As a part of my dry eye workup, I do anterior segment OCT to measure the exact degree of CC;  often, in dry eye patients, I find that CC sterically hinders the fornix tear reservoir thus effectively pushing out the tears. So, even though the patient has sufficient tear levels, the tears never reach the surface of the cornea. This was described in a paper by Tseng et. al.  (Conjunctivochalasis interferes with tear flow from fornix to tear meniscus. Huang Y1, Sheha H, Tseng SC. 2013 Aug;120(8):1681-7. doi: 10.1016/j.ophtha.2013.01.007).

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