Conjunctivochalasis surgery?

[autumnn]

Hi All- Since my optometrist mentioned to me in one visit that I had mild conjunctivochalasis, I sought out a doctor who is supposed to be pretty up to date with this condition. Anyway, when I went in to see him he said that my chalasis was "pronounced" and that I would likely benefit from the ATM surgery. The cost would only be $700 with my insurance.
The next day I saw my dry eye specialist optometrist and he said again that this chalasis was not my problem and warned against the surgery. Now I am so confused. I am definitely going to see a few more opthamologists to see what they think about this surgery for me before doing anything but I trust people on these boards so much too. I am so afraid of making things worse since there have been some general improvements. My eyes are usually white and I would hate for the surgery to make them red/bloodshot permanently. Also, of course, I would hate for them to be drier afterwards. However, I still have a lot of burning and the opthamologist I saw thought the surgery would help with this and now it is hard to get it out of my mind. The opthamologist is a cornea specialist named Dr. Hovanesian and he described it as a simple procedure that takes only 10 minutes- however he did warn about the risks that any surgery has. Any advice would be so greatly appreciated.
Oh, and my last question is- can conjunctivachalasis cause eyelid inflammation/irritation or does it just irritate the eye?
Thank you so much, Autumnn

[Lucy]

Hi Autumnn-
I have a case of being wide-awake in the middle of the night, so I'm checking out distress situations on DEZ. I'd like to put my two cents in here.

First, I've been on Dry Eye/Lasik Boards for 9 years. In that amount of time, you hear lots and lots of things that (may) fix, make better, help and assist in our situations. Well, there are also supplements galore. I can't tell you how many Rebecca, Mary, Diana and I have seen come and go over the years. None is a cure. Duh. (to me) I know about the Omega fats etc that have proven beneficial in the past few years. That's kind of a given health fact now, that the Omegas can help certain things and maybe help with dry eyes.

This conjunctivochalis stuff was not even heard of except for a handful of times on the boards over the past many years. All of a sudden, it seems to be popping up more and more. Does this mean there is more and more of the conjunct.? Does it mean that specialized docs are writing it up in journals more now. I'll bet you on that one. I'm not surprised your optometrist is warning you against this surgery. He can't make any money from you as he can't perform the surgery. That's a fact.

This surgery is normally very expensive. Florida seems to have several doctors who have made a name for themselves doing this surgery. Yes, I'm sure they are all equally good. You are worried about the surgery making your eyes more red and I'd say no doctor will be able to tell you he can keep your eyes from becoming more red by doing surgery.

Autumnn-sorry I rambled. But, unless you've had dry painful eyes for YEARS, do not do anything as drastic as this surgery. I have not had anything like this because I'm afraid of making things worse. Please be on the side of caution and WAIT, THEN WAIT SOME MORE before doing this. I know Mr. Esser on this board has had recent success with this surgery. I believe he has had more than one refractive surgeries on his eyes over a couple of decades. Please give time and caring docs a chance to make you feel better. Lucy......zzzzzzz still not ready for sleep.

[Richard Esser]

Diagnosing Conjunctivochalsis

Hi All- Since my optometrist mentioned to me in one visit that I had mild conjunctivochalasis, I sought out a doctor who is supposed to be pretty up to date with this condition. Anyway, when I went in to see him he said that my chalasis was "pronounced" and that I would likely benefit from the ATM surgery. The cost would only be $700 with my insurance.
The next day I saw my dry eye specialist optometrist and he said again that this chalasis was not my problem and warned against the surgery. Now I am so confused. I am definitely going to see a few more opthamologists to see what they think about this surgery for me before doing anything but I trust people on these boards so much too. I am so afraid of making things worse since there have been some general improvements. My eyes are usually white and I would hate for the surgery to make them red/bloodshot permanently. Also, of course, I would hate for them to be drier afterwards. However, I still have a lot of burning and the opthamologist I saw thought the surgery would help with this and now it is hard to get it out of my mind. The opthamologist is a cornea specialist named Dr. Hovanesian and he described it as a simple procedure that takes only 10 minutes- however he did warn about the risks that any surgery has. Any advice would be so greatly appreciated.
Oh, and my last question is- can conjunctivachalasis cause eyelid inflammation/irritation or does it just irritate the eye?
Thank you so much, Autumnn

Autumnn:

What strikes me odd about your eyes is the fact that they are so white. With pronounced conjunctivochalasis the conjunctiva is usually red and also the patient will suffer from subconjunctival hemorrhaging. Here are some tips on diagnosing conjunctivochalasis. 1. Rigorous blinking will genrally make the symptoms worse. 2. Patient will experience recurrent subconjunctival hemorrhages. 3. Fluorescein staining pattern will demonstrate a tear meniscus interruption 4. Tear clearance is frequently delayed and lastly, punctal occlusion will make the symptoms worse and the eye turn red. See another doctor. As Lucy stated if the procedure is done for the wrong reason it will not help.

Richard Esser

[autumnn]

Thank you Richard and Lucy. You both have such valid points and I am trying to digest them. I will definitely get more opinions and will take plenty of time to decide. It is tempting to rush into something that seems like a solution but as I said, I'd hate to open an entirely different can of worms. On the otherhand, there is always the chance that this opthamologist is correct and that I would benefit from the surgery.
Richard did your chalasis affect your eyelids at all? My opthamologist said that the loose conjunctiva can irritate the eyelids much like symptoms of MGD....
thanks again, Autumnn

[Francesco]

Yes conjunctivochalasis can affect the lids too...here you find a lot of information about it explained by Dr. Tseng..

http://www.osref.org/conjunctivochalasis-cch.aspx

[Richard Esser]

Irritated Eyelids

Thank you Richard and Lucy. You both have such valid points and I am trying to digest them. I will definitely get more opinions and will take plenty of time to decide. It is tempting to rush into something that seems like a solution but as I said, I'd hate to open an entirely different can of worms. On the otherhand, there is always the chance that this opthamologist is correct and that I would benefit from the surgery.
Richard did your chalasis affect your eyelids at all? My opthamologist said that the loose conjunctiva can irritate the eyelids much like symptoms of MGD....
thanks again, Autumnn

Autumn:

My complaint was not my eyelids. However, I was told that I had a moderate amount of posterior blepharitis which was irritating my conjunctiva. The lids scrubs and moist compresses nicely controlled the anterior blepharitis. Generally it seems that people with conjunctivochalasis also have blepharitis which aggravates the conjuctiva.

Richard Esser

[autumnn]

Thank you again for your responses. I had no idea that it affected the lids but it does make sense. I feel a constant burning around the temporal regions of my left eye and wonder if this is the chalasis.
Francisco thank you for that link and I looked at Dr. Tseng's website and it seemed to indicate the "mild" cases of conjunctivachalasis causes "unstable tear film" and "dry eye". So, this seems to indicate that a "mild" case of conjuncitvachalasis can feel not so mild to the person experiencing it.
Of course I would love to have the surgery and have excellent results but I could also live with having the surgery and having no results. I don't think I could endure having the surgery and becoming worse- that is my greatest fear. Does this board know of people who have been worse off after this surgery? I know Richard and another individual have been helped by this but I'd love to hear more from others- the internet is very sparse with this information.

[Lucy]

Autumnn, this procedure is not performed very often. It's not like finding out information on an appendectomy. This is very specialized. I also think that people who had not so good results from this surgery (or anything) they may not want to draw attention to their bad results as though it may be some fault of their own. Also, they might be asked to give their doctor's name and most forum's do not allow this. I wish you well on your decision. I just don't think you'll find (more than a few) people to post about this. Lucy

[autumnn]

Thank you Lucy. I understand what you are saying.....in the end, I have to decide if the potential benefits outweigh the risks.....unfortunately it all makes me a little sick to my stomach.

[Richard Esser]

RE: Chalasis surgery making patient worse

Thank you again for your responses. I had no idea that it affected the lids but it does make sense. I feel a constant burning around the temporal regions of my left eye and wonder if this is the chalasis.
Francisco thank you for that link and I looked at Dr. Tseng's website and it seemed to indicate the "mild" cases of conjunctivachalasis causes "unstable tear film" and "dry eye". So, this seems to indicate that a "mild" case of conjuncitvachalasis can feel not so mild to the person experiencing it.
Of course I would love to have the surgery and have excellent results but I could also live with having the surgery and having no results. I don't think I could endure having the surgery and becoming worse- that is my greatest fear. Does this board know of people who have been worse off after this surgery? I know Richard and another individual have been helped by this but I'd love to hear more from others- the internet is very sparse with this information.

Autumn:

I am not aware of any patients that have had the procedure and been made worse. I have read reports of individuals having this surgery who have derived no benefit. You are correct in that there is not a lot of information on the internet about the surgery. However, Dr. Tseng's Website is quite comprehensive. Furthermore, I know that even Dr. Tseng will not guarantee his patients up front that they will benefit. About all he can say is that the chalasis (pathology ) exits and it needs to be corrected.

Richard

[autumnn]

Thanks again for all the advice- now I have a strange question that I wonder if any of you experience that might be chalasis related- lately when I close my eyes to sleep I feel like my eyes are constantly making blinking motions like they are trying to adjust the conjunctiva. It feels like what the doctor explained is happening in my eye- the conjunctiva he said is slipping and moving a lot- it is all so strange But closing them all the way and having relief at night is hard- is making everything more difficult since sleep is sometimes my best relief. Can anyone relate to this?

[autumnn]

I'd love to bump this back to the open forum as I feel the need, so badly, for help here. I am scheduled for the 28th of January to have this surgery and am still unsure if I should do it and if it will even help me. I am so darn confused. The doctor who would perform the surgery believes there is a good likelihood that it will improve my symptoms- yet other doctors dont think the chalasis is my problem. I am feeling, and knowing, that I am acting out of desperation- at this point it just feels like I have tried everything and I cannot live like this one more day. Any advice and/or support would be so great.
Thank you in advance.

[Carlos 80]

So what was the outcome