Does anyone here have conjunctival chalasis (CCH)?

[Alix]

I was just re-reading the diagnosis sheet today from my last appointment at Moorfields 2 months ago and it says I have conjunctival chalasis (CCH). I remember the doctor telling me I had this but playing it down saying it was minimal and didn't require surgical correction.

I didn't pay much attention at the time as I hadn't heard of this condition before and didn't think it was related to my problems ie evaporative dry eye.

But now I have read up on it, there is apparently a link between CCH and dry eye in that it causes unstable tear film, inflammation etc and that in many cases people are misdiagnosed with dry eye when in fact they have CCH only, because the symptoms are similar. Some people have surgery and their "dry eye" problems are resolved.

I did say to myself I would never go to Moorfields NHS again, but since I have nothing to lose except my time, I will go there anyway in January for my next check up appointment and ask them more questions about CCH then.

In the meantime I was wondering if anyone had this, and if so, is it something that develops over time? Will this get worse for me? Is there anything I can do to stop this from progressing?

I am sure that my main issue is meibomian gland atrophia but the fact I have CCH however minimal it is, cannot be helping matters.

[TARYN]

My CCH was mild also. I tried drops and compresses but nothing helped except the excision of the conjunctival folds and the placement of the amniotic membrane over the area that was operated on. You are right about it causing an unstable tear film which produced the symptoms of inflammation, redness and burning. My tears were not fully covering and lubricating the ocular surface. It was an easy recovery and I felt relief from my symptoms immediately. I would assume it would have gotten worse if I did not take care of it, but I don't know how fast or slow it would have progressed.

[MGD1701]

Hi Taryn
thanks for sharing.
Did CCH cause you watery, gritty eyes? Did you have low TBUT?
I do know when one has CCH, MMP-9 could be positive too.

[TARYN]

My symptoms were burning, redness and inflammation and immediately after the surgery I felt relief from those symptoms. After then surgery for 3 weeks I used a steroid drop and an antibiotic drop. I was relieved that the burning and redness did not return when I stopped taking the drops. I had the surgery many years ago so I don't remember if I had a low TBUT.

[Guest]

My symptoms were burning, redness and inflammation and immediately after the surgery I felt relief from those symptoms. After then surgery for 3 weeks I used a steroid drop and an antibiotic drop. I was relieved that the burning and redness did not return when I stopped taking the drops. I had the surgery many years ago so I don't remember if I had a low TBUT.

Thanks for coming back and sharing this.

Alix
Looks like Ike you have an avenue to peruse. See what some docs say about your CCH. I think you’re onto something here.

[Alix]

My CCH was mild also. I tried drops and compresses but nothing helped except the excision of the conjunctival folds and the placement of the amniotic membrane over the area that was operated on. You are right about it causing an unstable tear film which produced the symptoms of inflammation, redness and burning. My tears were not fully covering and lubricating the ocular surface. It was an easy recovery and I felt relief from my symptoms immediately. I would assume it would have gotten worse if I did not take care of it, but I don't know how fast or slow it would have progressed.

Thank you this is very interesting. I have the same symptoms. The burning is more in the lower corners of my eyes which the doctor attributed to partial blinking/exposed sclera but it could be because I have CCH....the excess folds are there but only one doctor has picked up on it. I am wondering if it’s because it developed recently, in which case it wouldn’t explain why I’ve had burning pain for a year, or if it’s because it is so mild. The folds do not look as bad as the images I’ve seen on google.

When you had surgery how long did it take and were you able to go back into work the next day?

Also did the doctors mention anything about how to rid of the folds naturally or with an eye drop or is surgery really the only solution?

[Alix]

Thanks for coming back and sharing this.

Alix
Looks like Ike you have an avenue to peruse. See what some docs say about your CCH. I think you’re onto something here.

Possibly yes. The problem is there is an issue with every part of my eye so they are all contributing to the burning pain and redness I am suffering from....

[Guest]

Possibly yes. The problem is there is an issue with every part of my eye so they are all contributing to the burning pain and redness I am suffering from....

I understand, but if you treat the problems you know exist, you can start narrowing down the actual causes of the pain. This is the beginning of your road to recovery in my opinion. I think the cch is a huge issue. I’ve read throughout this process that even minor cch can cause huge burning. You may fix the cch and feel perfect regardless of the other issues. Only one way to find out sadly.

[TARYN]

Hi Alix You can go back to work immediately. I felt great right away. I had some redness from the surgery. That disappears slowly over a 3-4 week period . It disappears with time and with the help of steroid eyedrops. Also I flew in to Miami for the surgery, so I was fine flying home which was a 2 hour flight. And yes, Dr Tseng will prescribe the use of his preservative free steroid drops to see if it helps the problem so you can avoid surgery. I had the AMT surgery yeas ago for CCH and more recently for a pinguecula . For both problems I had great results.
With the CCH, I had redness and burning and with the pinguecula, I had tearing. For both problems, he excised the conjunctival tissue and then covered the area with amniotic membrane. For both it gave me a smooth ocular surface and stopped the burning, redness....and in the case of the pinguecula, it stopped the tearing

[TARYN]

I forgot to say, when I first started experiencing tearing, I thought i had a blocked tear duct. I went to an oculoplastic doctor and he tested to see if my tear ducts were blocked. The tear ducts were open so I then thought it might be the pinguecula. Since the tearing has stopped after the surgery, it was probably the pinguecula.

[MGD1701]

Hi Taryn
How did your doctor detect CCH and pinguecula? with dyes, if so, which one, just curious.

[TARYN]

Before I see him, his assistant does the full range of tests...dyes, TBUT, etc,. Plus he has a very powerful camera so you can see your eye in a very large format and see every detail of the surface of the eye. I could not see the conjunctival folds in real life but he took a video so you could see the folds moving. I could see the pinguecula in real life when I looked into a magnified mirror. It looked like clear bumps.

[Alix]

Hi Alix You can go back to work immediately. I felt great right away. I had some redness from the surgery. That disappears slowly over a 3-4 week period . It disappears with time and with the help of steroid eyedrops. Also I flew in to Miami for the surgery, so I was fine flying home which was a 2 hour flight. And yes, Dr Tseng will prescribe the use of his preservative free steroid drops to see if it helps the problem so you can avoid surgery. I had the AMT surgery yeas ago for CCH and more recently for a pinguecula . For both problems I had great results.
With the CCH, I had redness and burning and with the pinguecula, I had tearing. For both problems, he excised the conjunctival tissue and then covered the area with amniotic membrane. For both it gave me a smooth ocular surface and stopped the burning, redness....and in the case of the pinguecula, it stopped the tearing

This is good to know, thank you. If my condition does not improve with the Ikervis, I am going to ask about surgery when I go to Moorfields NHS in January. If they say no, I will go see a consultant at Moorfields private and get a second opinion. My company health insurance will cover the surgery costs so I have nothing to lose.

[Alix]

I understand, but if you treat the problems you know exist, you can start narrowing down the actual causes of the pain. This is the beginning of your road to recovery in my opinion. I think the cch is a huge issue. I’ve read throughout this process that even minor cch can cause huge burning. You may fix the cch and feel perfect regardless of the other issues. Only one way to find out sadly.

True, the burning sensation is right where the excess folds are. It would be so amazing if a simple surgery could fix the burning but I'll keep my expectations low as usual.
In the meantime I'll carry on taking the Ikervis, do a trial test of the scleral lens, and try and forget about it all until my next appointment at the hospital in January.

[TARYN]

Hi Alix. Make sure that after they excise the conjunctival folds that they cover the area with amniotic membrane. I think that is key to a successful outcome of having a smooth surface with no scarring and a quicker healing period.