Case-controlled clinical and histopathological study of conjunctivochalasis.
OBJECTIVE
Conjunctivochalasis, a secondary cause of the watery eye, is frequently seen in the older age group as an elevation of the bulbar conjunctiva lying along the lateral or central lower lid margin. A prospective, interventional, case-controlled clinical and histopathological study was conducted. The relevant features of 18 patients (29 eyes) who had their conjunctivochalasis resected as part of the surgical management of their watery eye syndrome were examined. In the control group, tissue was obtained from an age matched series of 24 normal subjects undergoing routine cataract surgery.


METHODS
24 controls (24 specimens) and 18 patients (29 specimens) had conjunctival strip biopsies, taken from the usual lid margin level bulbar conjunctiva in line with the inferior limbus (controls), and the clinically apparent conjunctivochalasis (patients). These were submitted for histological study.


RESULTS
23 of 24 control sections demonstrated normal conjunctival variation. Four of 29 patient specimens demonstrated a chronic non-granulomatous conjunctivitis, while three eyes of the patient group (two patients) demonstrated features of elastosis. Of the four patients who had the inflammatory infiltrates, three had functional nasolacrimal duct obstructions (FNLDOs) and one had a primary acquired nasolacrimal duct obstruction (PANDO). Of the two patients who had elastosis, one had an FNLDO and the other had normal lacrimal drainage and was Jones 1 positive.


CONCLUSIONS
Six of 18 patients--that is, seven of 29 specimens of conjunctivochalasis demonstrated signs of elastosis or of chronic non-granulomatous inflammation. Clinically, patients had a spectrum of aetiologies of their watery eye syndrome.
Francis
I C
IC
The Ocular Plastics Unit, Depratment of Ophthalmology, The Prince of Wales Hospital, Randwick, Sydney, Australia. if@student.unsw.edu.au
Chan
D G
DG
Kim
P
P
Wilcsek
G
G
Filipic
M
M
Yong
J
J
Coroneo
M T
MT
D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003228:Conjunctiva / Q000276:immunology / Q000473:pathology* / Q000601:surgery; D003229:Conjunctival Diseases / Q000276:immunology / Q000473:pathology* / Q000601:surgery; D015352:Dry Eye Syndromes / Q000473:pathology; D004548:Elasticity; D005143:Eyelids / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
Invest Ophthalmol Vis Sci. 2000 Feb;41(2):404-10
10670469
Surv Ophthalmol. 1998 Nov-Dec;43(3):225-32
9862310
Ophthal Plast Reconstr Surg. 2002 Jul;18(4):310-1; author reply 311-2
12142767
Br J Ophthalmol. 2003 Apr;87(4):396-8
12642297
Ophthal Plast Reconstr Surg. 2003 May;19(3):173-6
12918549
Br J Ophthalmol. 2004 Mar;88(3):388-92
14977775
Cornea. 2004 Apr;23(3):294-8
15084864
Oral Surg Oral Med Oral Pathol. 1978 Feb;45(2):232-45
272604
Aust N Z J Ophthalmol. 1987 Aug;15(3):185-91
3675910
Ophthal Plast Reconstr Surg. 1986;2(1):25-8
3154534
Cornea. 1991 Jul;10(4):367-8
1889225
Adv Exp Med Biol. 1994;350:1-710
8030458
Ophthal Plast Reconstr Surg. 1994 Jun;10(2):121-3
8086360
Ophthal Plast Reconstr Surg. 1994 Sep;10(3):185-7; discussion 188
7947445
Ophthalmologe. 1995 Dec;92(6):802-8
8563428
Cornea. 1996 May;15(3):295-300
8713933
J Cataract Refract Surg. 1998 Oct;24(10):1390-5
9795858
Invest Ophthalmol Vis Sci. 2000 Sep;41(10):2922-9
10967046