New Treatment for Conjunctivochalasis Avoids Surgery with Dr. Jaccoma
What is Conjunctivochalasis?
Conjunctivochalasis (or CCH for short) is a problem for many people. The conjunctiva should be smooth, moist, and attached firmly to the front of the eye. For example the lining of the inside of the mouth is similar. If you have a cut or canker sore in your mouth, you’re going to notice irritation when you’re chewing.
During conjunctivochalasis, the conjunctival membrane becomes loose and begins to fold over. It can even fold over the inner eyelid margin, meaning you’ll likely notice more tearing and tears that roll from the surface of the eye, on the conjunctiva, right onto the cheek. The conjunctiva will no longer be a smooth, tight membrane that your eyelids run over. Instead, there will be increased friction. Every time you blink, there is a lack of lubrication and more friction than normal when the eyelids blink over the conjunctiva.
In addition to this, there’s usually a constant turnover of tears so that old tears are replaced with fresh new ones. With conjunctivochalasis, this turnover is disrupted.
What Causes Conjunctivochalasis?
Inflammation on the surface of the eye causes the conjunctiva to become swollen, wrinkled and loose in some patients. Chronic inflammation can lead to conjunctivochalasis and worsen dry eye disease.
How do you treat Conjunctivochalasis? Conjunctivochalasis Surgery and Treatment
Although you may try artificial tears or topical medications, these are simply bandaids for the underlying problem. They’re not going to get to the root of the issue and provide your eyes with the relief you’re searching for.
This means having the membrane partially cut away. This is a common procedure for this condition, but there are issues with this surgery. By cutting away the membrane, you are also cutting off part of the cells and glands that would be making a portion of your tears.
Because this surgery isn’t an ideal fix, an amniotic membrane is often used along with the surgery. An amniotic membrane contains enzymes, proteins, and growth factors that can help the conjunctiva heal itself in a better way. However, you’re still dealing with the fact that you’ve undergone an operation that’s disrupted your conjunctiva and the cells and glands involved.
Cautery is also an option for conjunctivochalasis, which would create a smaller area to be healed. However, when you char tissue, it takes much longer to heal and you still haven’t really fixed the underlying issue. Your eyes will still be dry, and this is a problem.
Radio Frequency for Conjunctivochalasis
Radio frequency is a new technology used off-label in eye care, and it can have great benefits for conjunctivochalasis. Dr. Jaccoma routinely uses a radio frequency procedure to treat the meibomian glands in those with meibomian gland dysfunction (MGD). You can learn more about that in this interview, but it uses heat to help heat the hardened, stagnant oil in the meibomian glands and allow the oil to flow more freely onto the surface of the eyes.
Radio frequency treatment has shown promise in his practice for the treatment of conjunctivochalasis as well. During the procedure, the eye is numbed a few different ways so the patient is completely comfortable. The procedure takes just minutes and treats the meibomian glands as well as irons out the pleats and folds of the conjunctiva.
Substantial CCH can often be dealt with simply by fixing the meibomian gland dysfunction and increasing the quality of the tears. If there is still an issue for the patient after having a few treatments, and the underlying issue has been addressed, a conjunctivoplasty may be considered.
Conjunctivochalasis Home Remedy - Getting to the Source of the Problem
Despite all of the fancy treatments, it’s still necessary to continue treating your dry eye, blepharitis, or MGD as you normally would with eyelid hygiene. This is important because bacteria will never go away and can always contribute to these ocular health issues.
Make sure to thoroughly remove all makeup at the end of the day and wash your face with a tea tree oil soap. This is important because forgetting to wash your face means you’re allowing excess bacteria to accumulate on your sensitive eyelids. In addition, most makeup is full of chemicals that shouldn’t be near your eyes. An increase in bacteria and chemically-laden products around your eyes can increase inflammation.
After you’ve washed your face, use a warm compress eye mask to maintain healthy oil flow. Simply place the mask into the microwave for 20 seconds and place it over your closed eyelids for 10-20 minutes. Relax and enjoy the relief! If you suffer from rosacea, you may want to alternate warm and cool compresses, as a warm compress can sometimes make symptoms worse in those individuals.
Because eyelid hygiene is so important, that should be the last big step in your routine. Use a hypochlorous acid cleanser to clean your eyelids twice daily. Simply spray the solution onto your closed eyelids, rub it in, and let it dry. This helps keep the bad bacteria in check without disrupting the healthy bacteria your eyelid skin needs.
Lastly, consider taking a high-quality omega-3 supplementto enhance the quality of the oil your meibomian glands produce. Make sure you’re eating healthy fats in general, such as avocados, extra virgin olive oil, nuts, and seeds. Make sure you’re hydrating yourself every single day! Don’t underestimate the benefits of drinking half your body weight in ounces of water per day (that’s 75 ounces for a 150 pound person). As always, discuss any health changes with your doctor before beginning a new regimen.
What causes Conjunctivochalasis?
Inflammation on the surface of the eye can lead to conjunctivochalasis. This is most often due to dry eye disease, but it could potentially occur due to allergies or other ocular surface issues as well. When the conjunctiva becomes inflamed, it begins to swell, wrinkle, and loosen from the front surface of the eye.
Why is the skin on my eyeball loose?
This condition is known as conjunctivochalasis, which is characterized by having excess folds of conjunctival skin which accumulate between the eyeball and the inside surface of the eyelids. This can cause irritation and a constant feeling like you have something in your eye.
Is there a layer of skin on your eye?
There is a clear layer of skin covering the front of your eyeball, and this is called the conjunctiva. It covers the white portion of your eye, your sclera, but does not cover your cornea on the very front. The cornea is the sensitive tissue that domes over the iris, or the colored portion of your eye.
How do you treat Conjunctivochalasis?
To treat CCH, you must treat the underlying problem. Inflammation due to dry eye disease, meibomian gland dysfunction, blepharitis, and sometimes allergies can contribute to this condition. To treat the underlying issue, maintain proper eyelid hygiene. Consider having a heating procedure performed, such as Intense Pulsed Light (IPL) or LipiFlow, to maintain healthy oil and tear production. Once the underlying issue is dealt with properly, a conjunctivoplasty may be considered.
About Dr. Jaccoma
Dr. Edward H. Jaccoma is a Board Certified Ophthalmologist who has recently relocated to Connecticut after practicing in the Southern Maine area for 30 years. He specializes in General Ophthalmology, the medical and surgical management of dry eye-related disorders, as well as plastic surgeries of the eye and eyelid areas
Dr. Jaccoma received his Medical degree from the University of Vermont where he graduated with a nomination to the Alpha Omega Alpha Honorary Society and his Bachelor of Science degree from Fairfield University.
He completed his internship in Internal Medicine at the Washington Hospital Center and his residency in Ophthalmology at the University of Virginia. He has also taught medical students and resident physicians at the University of New England College of Medicine, as well as serving as Medical Director of Medispas, delivering laser, injections, IPL, radiofrequency and surgical aesthetic care.
Additionally, Dr. Jaccoma will perform cosmetic eyelid procedures and will offer treatments for reducing the appearance of wrinkles and rejuvenating the skin and will also be working to develop OptiCare’s Dry Eye Center.
Dr. Jaccoma is a member of the American Academy of Ophthalmology and a Fellow of the American Medical Association.