Conjunctivochalasis is a degenerative change in the conjunctival tissues of the ocular surface. The degenerative changes are characterized by a loosening of the conjunctiva and its attachments to the eye. This causes a redundancy and wrinkling of the conjunctiva.

These changes could occur at any site of the conjunctiva. Most commonly it is symptomatic when present in the outer corner of the eye where it misdirects the tear flow to the outer corner rather than across the corneal surface toward the natural drain of the tear film at the inner corner where the puncta are located.

The wrinkling of the conjunctiva increases the surface area for the tears and may consequently increase tear evaporation. Conjunctivochalasis is also associated with decreased tear clearance, meaning that if irritants, allergens, toxins, pollutants, etc., get into an eye with this abnormality then the eye is less likely to be able to clear these inflammatory agents from its surface, creating an ongoing chronic, usually low-grade, but could be moderate to severe inflammatory state.

Surface reconstruction using amniotic membrane leaves the surface smooth and clear. Patients remark at how comfortable the eye feels and often state how their vision has improved. The improvement in vision is probably from the enhanced tear flow and distribution over the cornea that occurs. I have at least two macular degeneration patients that were told nothing could be done for their count finger vision. These same patients can now see 20/200 because I resurfaced their eyes with amniotic membrane and the enhanced tear flow has enabled them to enjoy their potential vision which had been hidden due to poor tear flow. It was assumed that they would never see the eye chart again.

Regarding both rigid and soft contact lens wear: At times patients are unable to wear contacts due to inadequate tear volume and distribution. Resurfacing the eye restores more normal tear flow and distribution over the cornea, making for improved lens lubrication movement and comfort. In addition, soft contact lens wearers at times have difficulty wearing their lenses due to mechanical microtrauma from the wrinkling and folds in the conjunctiva, which may subluxate and eventually dislocate a soft lens. Moreover, this microtrauma can further increase the surface inflammation,which leads to further discomfort and secondary cornea erosions with potential infection, etc.