Presentation
A 78-year-old woman with a history of diabetes and hypertension presented complaining of significant ocular surface symptoms: burning, irritation, and foreign body sensation, but primarily tearing. Prior treatment included warm compresses, artificial tears, and cyclosporine drops.
Diagnosis and Treatment
I diagnosed conjunctivochalasis, and I performed surgical conjunctivochalectomy with inferior fornix reconstruction using AmnioGraft and fibrin glue. The patient had an excellent recovery. At 2-weeks post-op, she was eager to have the same procedure on the fellow eye (which had identical disease), and by 4-weeks post-op she described feeling very comfortable and having no foreign body sensation.
Observations
This patient was previously seen by several ophthalmologists who treated her symptoms as dry eye disease and did not take into consideration the loss in anatomic structures that were causing alterations in the physiologic tear mechanisms. Resecting the conjunctivochalasis and restoring the normal conjunctival anatomy with the use of AmnioGuard to prevent scarring complications eliminated the patient’s symptoms and restored her quality of life.
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