Mechanical Dry Eye, also known as Conjunctivochalasis (CCh), is often misdiagnosed or overlooked because the symptoms are very similar to other types of Dry Eye Disease. There is a thin clear layer of tissue between the eye and the eyelid called the conjunctiva. The conjunctiva extends from the edge of the cornea to the inside of the eyelid. It acts like a pocket that holds a reservoir of tears, keeping the eyes lubricated and comfortable with each blink. For some people, this tissue can loosen and wrinkle with age, disrupting the normal process that lubricates the eyes. This condition is called conjunctivochalasis. The wrinkling and loosening of the tissue force the tears out, and the eyes become dry, irritated, and vision can be affected.
Dryness/Redness
The absence of adequate tears can lead to an increased risk of eye infection. If left untreated, severe dry eyes can lead to inflammation, corneal abrasion, ulceration, and other ophthalmic problems.
Excessive Tearing
Mechanical Dry Eye is a type of dry eye that can be frustrating to patients. Mechanical Dry Eye can cause excessive tearing due to obstructed tear reservoir or fornix, blocked punctum or tear meniscus.
Eye Pain
Eye pain may be significant in Mechanical Dry Eye patients, especially when blinking or gazing down. It can get worse in the morning upon waking-up in the majority patients.1
Sensitivity Loss
The redundant folds of conjunctiva may damage the tear film stability. Tear film changes may cause irregularities of the corneal surface, which may reduce the contrast sensitivity and contribute to blurry vision.1
“The Reservoir Restoration method offers unparalleled benefits to patients with Conjunctivochalasis (CCh): improved tear drainage, restored normal anatomy and blinking, and reservoir capacity. This restored mechanical function is what provides the symptomatic relief that the patient experiences.”
– Arla Genstler, MD – Genstler Eye Center – Topeka, KS
“For patients with Dry Eye Syndrome that do not respond to conventional topical therapies, or for patients who have purely visual symptoms of Mechanical Dry Eye, the Reservoir Restoration procedure with cryopreserved amniotic membrane offers the chance at significant relief by reducing inflammation, promoting regenerative healing, suppressing pain, and improving visual and tear film stability.”
– Neel Desai, MD – The Eye Institute of West Florida – Largo, FL
“Conjunctivochalasis (CCh) symptoms can be frustrating, especially for the patient, as well as the doctor. Making the diagnosis is the key to effective treatment. The Reservoir Restoration procedure is very effective for patients who are suffering from mechanical dry eye issues. It allows them to recover quickly and get back to their active lifestyles.”
– Clifford Salinger, MD – V.I.P. Laser Eye Center – Palm Beach Gardens, Florida
SHORT TERM
When patients become symptomatic, ocular lubricants are often the first line of treatment for Mechanical Dry Eye, as they can replace reduced tear film on the eye. Prescription eye drops are often used to help the eye produce more tears. However, ocular lubricants and prescription eye drops only provide short term relief for the patient, they do not solve the root cause of Mechanical Dry Eye.
LONG TERM
For long term relief from Mechanical Dry Eye, your eye doctor may recommend an outpatient procedure that will help restore normal eye function and appearance. This procedure is known as Reservoir Restoration. During this procedure, your eye doctor will surgically restructure the conjunctiva blocking the tear reservoir in your eye.
Your normal anatomical reservoir can be restored using AmnioGraft, a biologic ocular transplantation graft. This adjunct therapy addresses the root cause of your dry eye, with most patients experiencing a fast recovery and significant reduction in inflammation.
References:
1 Qiu, W., Zhang, M., Xu, T., Liu, Z., Lv, H., Wang, W., & Li, X. (2016). Evaluation of the Effects of Conjunctivochalasis Excision on Tear Stability and Contrast Sensitivity. Scientific reports, 6, 37570. doi:10.1038/srep37570
2 Mimura, T., Yamagami, S., Usui, T., Funatsu, H., Mimura, Y., Noma, H., … & Amano, S. (2009). Changes of conjunctivochalasis with age in a hospital-based study. American journal of ophthalmology, 147(1), 171-177.
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