Conjunctivochalasis is a degenerative eye condition that occurs when the conjunctiva, the moist tissue layer that protects the whites of your eye, loosens and folds. It’s thought to be caused by the breakdown of elastic fibers underneath the conjunctival surface.

Conjunctivochalasis is a fairly common eye condition that causes the conjunctiva — the clear moist tissue layer that covers the inner eyelids and the white part of your eye — to loosen, wrinkle, and fold. This can cause symptoms such as dry eye, eye discomfort, and blurry vision.

Conjunctivochalasis usually affects both eyes. It is more common with age and is sometimes thought to be related to the natural degeneration of elastic fibers within connective tissue as you age. This condition can sometimes be misdiagnosed as dry eye or may not be diagnosed at all.

This article takes a closer look at the causes and symptoms of conjunctivochalasis, the typical treatment, and recovery.

The cause of conjunctivochalasis is unknown. It’s thought that the the normal bundles of elastic fibers within the conjunctival connective tissue break down with time and age.

Conjunctivochalasis may result from the natural breakdown of normal bundles of elastic fibers within the conjunctival connective tissue or trauma that causes damage to these fibers. For instance, vigorous eye rubbing, eye irritation, and abnormal eye positions may affect the fibers in your eyes and cause them to break down.

The symptoms of conjunctivochalasis can vary. Some people have none or very mild symptoms. Other people experience severe symptoms that interfere with their daily lives.

Symptoms of conjunctivochalasis can include:

People with conjunctivochalasis often experience dry eyes or eye irritation. Conjunctivochalasis often disrupts the normal surface of the eye and interferes with the eyelids’ ability to provide a consistently moist tear film across the eye’s surface.

In extreme cases, the floppy, redundant conjunctiva can prevent the eyelids from fully closing, leading to problems with corneal exposure. Sometimes, as happens to everyone, dry or itchy eyes can be caused by dry air, allergens, or exposure to toxins.

It’s a good idea to see a doctor if:

  • you have any symptoms that last for more than a few days
  • your symptoms are severe
  • your symptoms seem to be getting worse

It’s best to see an eye specialist, such as an ophthalmologist. They’ll have the proper diagnostic equipment and expertise to determine whether you have conjunctivochalasis.

It can be challenging to diagnose conjunctivochalasis because the symptoms are similar to other eye conditions, such as dry eye.

If your doctor thinks you might have conjunctivochalasis, they’ll likely do a test called a slit-lamp examination.

This test uses a slit lamp microscope that focuses a narrow beam of light into your eye. This gives your doctor a magnified view of your eye, allowing them to see the various structures of your eye more clearly.

A slit lamp microscope helps your doctor detect abnormalities in your eye, including loose and folded conjunctiva.

Doctors grade conjunctivochalasis on a scale based on the number of folds and the height of the folds.

  • Grade 0: No persistent fold
  • Grade 1: One single small fold
  • Grade 2: Two or more folds that are not higher than the tear meniscus
  • Grade 3: Multiple folds that are higher than the tear meniscus

The treatment for conjunctivochalasis depends on your symptoms. You typically won’t need treatment if you have conjunctivochalasis but don’t have symptoms. Treatments may include artificial tear eye drops or topical corticosteroids if you have mild symptoms.

If you have conjunctivochalasis with severe symptoms, you may need surgery to help relieve your symptoms. Surgical options include removing part of the excess conjunctiva and smoothing out the remaining tissue.

There are a few methods for removing excess conjunctiva, such as:

  • thermal cautery, which uses heat to destroy extra tissue
  • argon laser to shrink the excess tissue
  • conventional eye surgery to remove excess tissue

Your eyes will likely be red and irritated for about 48 hours following the surgical removal of excess conjunctiva. You might also have pain and discomfort for the first few days.

Typically, most of the discomfort will ease within a few days. It’s common to experience some redness, mild irritation, and some tearing for about 2 to 3 weeks following surgery. You’ll need follow-up visits with your surgeon to ensure your eye is healing properly.

Your surgeon will prescribe eyedrops to be applied in the days or weeks following surgery. Using them exactly as directed is essential to promote eye healing and recovery.

For many people, surgery will alleviate symptoms. However, even after you’ve recovered, it’s vital to see your eye doctor regularly to ensure your eyes are healthy and that no new folds are forming in your conjunctiva.

Conjunctivochalasis is a common eye condition often mistaken for dry eye. This degenerative condition occurs when the conjunctiva, the moist tissue layer that protects the whites of your eye, loosens and folds. This can cause your eyes to be dry, itchy, sensitivity to light, and blurry vision.

Some people have no symptoms or very mild symptoms. In this case, treatment usually isn’t necessary. If you have conjunctivochalasis with mild symptoms, treatment with eye drops or topical gels may be sufficient. If your symptoms are severe, surgery may be the best option.