Conjunctivochalasis. A cause of tearing and its management

Conjunctivochalasis is an isolated bilateral condition in which redundant conjunctival tissue overlies the lower eyelid margin or covers the lower punctum. It causes tearing by mechanically disrupting the normal flow of tears. Unlike the boggy conjunctiva seen in an allergic reaction, the extent of this redundant tissue is small, well-localized, and unresponsive to antihistamine drops. During the 40-month period from May 1981 through September 1984, 15 patients complaining of epiphora were found to have this problem. Simple local surgical excision relieved their symptoms. Follow-up period ranged from 10 to 40 months, with an average of 27 months. Conjunctivochalasis can be recognized by a thorough ocular examination and managed by simple excision of the redundant tissue. Consequently, before extensive surgery such as dacryocystorhinostomy, eyelid surgery, or silicone intubation of the lacrimal system is contemplated, conjunctivochalasis should be ruled out and corrected.