I was an early adopter of identifying conjunctivochalasis (CCh) and addressing it as a true pathologic condition from which our patients suffer. Conjunctivochalasis dry eye, as it is often called, is truly a misnomer. While CCh contributes to dry eye symptoms, it is a separate entity from the “standard dry eye” that we see in our practices. Furthermore, a number of myths are associated with CCh.
CCh presents as dissolved and degenerated Tenon’s with excess, loose conjunctiva in the inferior fornix, and fat prolapsed into the inferior cul-desac. This results in both the obliteration of the tear reservoir within the inferior fornix and obstruction of the tear meniscus along the inferior eyelid margin. Normal tear distribution and outflow are disrupted, and the patient experiences dry eye symptoms.