What is Conjunctivochalasis?
Conjunctivochalasis is a common but under-recognised condition which is often confused with dry eye. Conjunctivochalasis occurs when the adhesions between the conjunctiva and underlying sclera break down, usually as an age-related phenomenon. This allows "slippage" at every blink with resulting inflammation and pain. My experience is that it is under-diagnosed, which is a pity as excellent treatment is available, and can be discussed at the time of a consultation. Many patients with "dry eye syndrome" who do not respond to treatment actually have underlying, unrecognised conjunctivochalasis.
The exact treatment is complex, but includes simple lubricants and then incremental use of anti-inflammatories and finally surgery. The aim of such surgery is to prevent the slippage that occurs with every blink and which is the cause of symptoms. Usually such surgery is incremental starting with simple diathermy to create adhesions, but if this is insufficient then a conjunctival resection is almost always successful. Some surgeons use amniotic membrane patching, but other that a significant increase in cost I cannot see the logic as the well-recognised anti-inflammatory properties of amniotic membrane are likely to reduce the adhesions between the conjunctiva and the sclera which is the object of the surgery.