Dry Eye Dx and Tx: Conjunctivochalasis—The Dry Eye “Mimicker”
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By
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TIFFANY ANDRZEJEWSKI, OD
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March 1, 2026
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5 min
Clinical Report: Dry Eye Dx and Tx: Conjunctivochalasis—The Dry Eye “Mimicker”
Overview
Conjunctivochalasis (CCh) is a prevalent condition in older adults that mimics dry eye disease (DED) symptoms. It is characterized by redundant conjunctival folds that disrupt tear film dynamics, leading to discomfort and inflammation.
Background
CCh is increasingly recognized as a significant contributor to ocular surface symptoms, particularly in individuals aged 60 and older, where its prevalence can reach up to 98%. Understanding CCh is crucial for accurate diagnosis and management of DED, as it can exacerbate symptoms and complicate treatment. The condition is often underdiagnosed, leading to persistent discomfort in patients despite standard dry eye therapies.
Data Highlights
No numerical data provided in the source material.
Key Findings
- CCh affects 44% to 98% of individuals aged 60 and older.
- It can cause mechanical dry eye symptoms that worsen with blinking.
- Diagnosis is primarily through slit lamp examination and visualization techniques.
- Initial treatments include topical steroids, immunomodulators, and preservative-free artificial tears.
- In-office procedures may be necessary for moderate to severe cases, including plasma pen conjunctivoplasty.
- Identifying CCh is essential for managing DED, especially in patients with persistent symptoms.
Clinical Implications
Healthcare professionals should be vigilant in diagnosing CCh in older patients presenting with dry eye symptoms. Effective management may require a combination of medical therapies and surgical interventions to address the underlying structural issues.
Conclusion
CCh is a significant factor in the management of dry eye disease, necessitating a thorough evaluation and tailored treatment approach to improve patient outcomes. Awareness and education about CCh can enhance patient understanding and satisfaction with their treatment.
References
- Marmalidou A, Palioura S, Dana R, Kheirkhah A, Ocul Surf, 2019 -- Medical and surgical management of conjunctivochalasis
- Chhadva P, Alexander A, McClellan AL, et al, Invest Ophthalmol Vis Sci, 2015 -- The impact of conjunctivochalasis on dry eye symptoms and signs
- Yokoi N, Komuro A, Nishii M, et al, Cornea, 2005 -- Clinical impact of conjunctivochalasis on the ocular surface
- Huang Y, Sheha H, Tseng SC, Ophthalmology, 2013 -- Conjunctivochalasis interferes with tear flow from fornix to tear meniscus
- Erdogan-Poyraz C, Mocan MC, Irkec M, et al, Cornea, 2007 -- Delayed tear clearance in patients with conjunctivochalasis is associated with punctal occlusion
- Li DQ, Meller D, Liu Y, Tseng SC, Invest Ophthalmol Vis Sci, 2000 -- Overexpression of MMP‑1 and MMP‑3 by cultured conjunctivochalasis fibroblasts
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