Dr Ben Wild
Overview |
Conjunctivochalasis and dermatochalasis refer to the development of excess tissue. They describe conditions of excess conjunctiva, a clear layer of tissue above the sclera (white part of the eye) and excess eyelid skin, respectively.
Frontal view of a healthy eye.
Conjunctivochalasis, more specifically, is seen as 1 or more folds of extra conjunctiva poking out from underneath the lower eyelid. This condition interferes with the normal tear flow and if severe, can scratch the cornea. This is a major, often underdiagnosed, cause of dry eye.
Frontal view of an eye with conjunctivochalasis above the bottom eyelid.
Dermatochalasis, most commonly, is seen as the overhanging of excess eyelid skin of the upper eyelids. However, it can refer to baggy lower eyelids. When affecting the upper eyelids, the added weight of the extra skin can cause the eyelids to droop and limit someone’s vision.
Frontal view of an eye with dermatochalasis of the upper lid.
Signs and Symptoms |
Signs
Conjunctivochalasis | Red eyes, a semi transparent/off white fold of tissue protruding from underneath the lower eyelid. |
Dermatochalasis | Many upper or lower eyelid skin folds, droopy eyelids. |
Symptoms
Conjunctivochalasis | Itchy, dry eyes, foreign body sensation, tears streaming down cheeks. |
Dermatochalasis | Loss of superior vision, difficulty keeping eyes open. |
Causes and Risk Factors |
Causes
Excess skin (either epidermal or conjunctival).
Risk Factors
Increased age, history of ocular allergies or other causes of eyelid swelling such as thyroid eye disease, infections, etc., and chronic ocular surface disease/dry eyes.
Prevention and Treatment |
Prevention
Treat allergies, ocular swelling, and/or dry eyes.
Treatments
Conjunctivochalasis:
· Artificial tears.
· Topical non-steroidal anti-inflammatories.
· Topical steroid drops.
· Surgery (resection/dissection/cautery).
Dermatochalasis:
· Glasses crutch (an arm extending from glasses that hold the eyelids up).
· Surgery (blepharoplasty).
Prognosis |
Conjunctivochalasis can rarely cause permanent corneal scarring but typically would not result in loss of any vision. It most often contributes to symptoms related to dry eye. Treatments listed above tend to work very well.
Dermatochalasis is not a vision threatening condition, but if left long enough, can lead to temporary loss of superior vision (because the top of the pupil is covered by the eyelid). This restriction would be restored following surgery.
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