Presentation
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]
Entire Body System
- Asymptomatic
In this study of 24 patients with conjunctivochalasis (8 asymptomatic and 16 symptomatic), 9 pateints underwent operative correction.[5] The study found that the recovery rate of the tear meniscus was significantly slower in symptomatic than asymptomatic [eyewiki.aao.org]
Asymptomatic patients don’t require treatment. For symptomatic patients, conservative treatment is initially targeted at lubrication of the ocular surface. [reviewofophthalmology.com]
Treatment[edit] Mild Conjunctivochalasis can be asymptomatic and in such cases does not require treatment. [en.wikipedia.org]
In management of CCh, treatment is not recommended if the patient is asymptomatic. For those patients with severe disease, medical therapy can be suggested. [dovepress.com]
Eyelid disorders, including meibomian gland dysfunction, floppy eyelid syndrome, entropion, often co-exist with CCh and can exacerbate the inflammatory process and development of the characteristic folds.[28] Treatment / Management For asymptomatic CCH [ncbi.nlm.nih.gov]
- Surgical Procedure
In this surgical procedure, a crescent-shaped area of the conjunctiva is recessed along a limbal peritomy with a maximum anterior-posterior width no more than 3 mm. Diseased and dissolved Tenon’s are undermined leaving a large bare scleral defect. [en.wikipedia.org]
With surgical procedures, the risk of cicatricial changes, symblepharon formation and shortening of the fornix are important risks to consider, as they can lead to worsening symptoms. [reviewofophthalmology.com]
procedures used to correct CCh with respective advantages and disadvantages The majority of these procedures involve excising or resecting the conjunctiva and may be effective as they relieve the mechanical obstruction. [ncbi.nlm.nih.gov]
- Localized Pain
pain, foreign body sensation, subconjunctival hemorrhage and ulceration. [en.wikipedia.org]
Symptoms often include mild irritation, foreign body sensation, localized pain, tearing, blurred vision, burning, mucus discharge and nocturnal lagophthalmos. [reviewofophthalmology.com]
Skin
- Ulcer
[…] 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 to localized pain, foreign body sensation, subconjunctival hemorrhage and ulceration [en.wikipedia.org]
The cornea may be clear or have punctate staining, as well as dellen formation adjacent to the redundant conjunctiva, or marginal ulcers. [reviewofophthalmology.com]
Eyes
- 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]
- Chemosis
In mild to moderate cases, topical drops can tackle chemosis and inflammation. As mentioned previously, the presence of CCh exhibits a strong positive predictive value in the diagnosis of KCS. [ncbi.nlm.nih.gov]
After the procedure, patients may experience mild irritation, foreign body sensation, hyperemia, chemosis and subconjunctival hemorrhage—all of which are self-limited. [reviewofophthalmology.com]
- Blurred Vision
When severe, CCH can also lead to blurred vision, mucous discharge, dryness, ocular fatigue, and subconjunctival hemorrhage. CCH is usually bilateral and most commonly involves the inferotemporal conjunctiva. [eyewiki.aao.org]
Symptoms often include mild irritation, foreign body sensation, localized pain, tearing, blurred vision, burning, mucus discharge and nocturnal lagophthalmos. [reviewofophthalmology.com]
- Lagophthalmos
Patients experiencing nocturnal lagophthalmos may benefit from nighttime lubricating ointment and patching to protect the ocular surface. [reviewofophthalmology.com]
[…] prone to rupture when blinking), swollen puncta, and anterior migration of the mucocutaneous junction (likely secondary to the delayed clearance of inflammatory proteins).[20] Furthermore, it is important to confirm whether there is any evidence of lagophthalmos [ncbi.nlm.nih.gov]
- Conjunctival Injection
injection from inflammation and lagophthalmos. [reviewofophthalmology.com]
Psychiatrical
- Suggestibility
Pathogenesis The exact mechanism for conjunctivochalasis development isn’t known, but the literature suggests that it’s multifactorial.5,6 One thing we do know is that this condition is associated with pterygia and pingueculae. [reviewofophthalmology.com]
Initially, a senile process related to conjunctival laxity was suggested in the 19th century. [dovepress.com]
[…] impaired lymphatic flow, resulting in lymphatic dilation and clinically redundant conjunctiva. [3] Even though there is little to no histopathologic evidence to support inflammation as a major contributor to conjunctivochalasis, mechanistic evidence suggests [eyewiki.aao.org]
It is not clear whether there are inflammatory cells in the conjunctival folds.[16][17] The contradictory findings and absence of statistical difference in histopathological studies may suggest that the pathology of CCh may not lie in the conjunctival [ncbi.nlm.nih.gov]
Neurologic
- 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]
Treatment
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 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]
Etiology
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
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]
Pathophysiology
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]
Prevention
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]
PRIMA DELL’INTERVENTO DI CHIRURGIA REFRATTIVA - LASER 100,00€ VISITE PER LA MEDICINA DEL LAVORO E PER LA PATENTE DI GUIDA 75,00€ PRESCRIZONE DELLE LENTI A CONTATTO MORBIDE 60,00€ PRESCRIZONE DELLE LENTI A CONTATTO SEMIRIGID 75,00€ VISITE OCULISTICHE PREVENTIVE [hawlina.eu]