Clinical Scorecard: Dry Eye Dx and Tx: Conjunctivochalasis—The Dry Eye “Mimicker”

At a Glance

Key Highlights

• CCh presents symptoms similar to dry eye disease (DED).
• Diagnosis is primarily through slit lamp examination and vital dye application.
• Initial treatment includes topical therapies; advanced cases may require surgical intervention.
• CCh can worsen DED symptoms and is often unrecognized.
• Practitioners should educate patients on CCh to improve understanding of persistent symptoms.

Guideline-Based Recommendations

Diagnosis

• Use slit lamp examination to identify redundant conjunctival tissue.
• Apply vital dyes to visualize folds and assess tear film.

Management

• Initial treatments include topical steroids, immunomodulators, and preservative-free artificial tears.
• Consider in-office procedures like plasma pen conjunctivoplasty for moderate to severe cases.

Monitoring & Follow-up

• Assess symptom improvement and ocular surface condition regularly.

Risks

• Untreated CCh can lead to chronic discomfort and worsening dry eye symptoms.

Patient & Prescribing Data

Older adults, particularly those with persistent dry eye symptoms.

Conservative medical therapy is the first step; surgical options may be necessary for severe cases.

Clinical Best Practices

• Educate patients about the relationship between CCh and DED.
• Perform thorough examinations to identify CCh in symptomatic patients.
• Consider a multidisciplinary approach for managing complex cases.

References

• Marmalidou et al, 2019
• Chhadva et al, 2015
• Yokoi et al, 2005
• Huang et al, 2013
• Erdogan-Poyraz et al, 2007
• Li et al, 2000
• Hillman, 2021