Conjunctivochalasis and chemosis ; Conjunctival chalasis, conjunctival oedema.(Brief Article)

Description

Conjunctivochalasis refers to a chronic degenerative loosening and redundancy of the conjunctiva. The conjunctiva remains largely aligned with the ocular surface and so the subconjunctival space is not significantly expanded. Conjunctivochalasis is most commonly seen with ageing of the ocular surface. However, it may also result from prolonged conjunctival oedema as occurs with thyroid eye disease, ocular allergic conditions and some orbital tumours.

Chemosis (conjunctival oedema) may occur acutely in many different conditions including allergic conjunctivitis, bacterial conjunctivitis and chemical burns. Chronic chemosis is less common and can occur with orbital tumours, thyroid eye disease or as an idiopathic finding. Chemosis results from conjunctival inflammation with extravasation of fluid from the conjunctival blood vessels leading to expansion of the sub-conjunctival space. The conjunctiva is elevated from the sclera, giving the eye a bulbous appearance.

Symptoms

With conjunctivochalasis, patients may report chronic ocular surface irritation with foreign-body sensation and increased lacrimation. In contrast, chemosis symptoms reflect the cause - for example, the symptom of itching in allergic conjunctivitis.

Signs

Conjunctivochalasis: The redundant inferior conjunctiva is often slightly inflamed, forming a horizontal ridge of tissue that prolapses over the inferior eyelid margin. The ridge of conjunctiva, tarsal surface of the inferior lid margin and inferior cornea all stain moderately with fluorescein and rose bengal. Changes are usually bilateral. Occasionally sufficient redundancy occurs that the inferior conjunctiva forms a ridge of tissue rubbing on the cornea.