Among the mechanical problems related to dry eye is conjunctivochalasis—the Tenon’s capsule condition in which long-term chronic inflammation and dry eye causes dissolution of normal Tenon’s fascia.
The conjunctiva becomes loose (not redundant), shortening the inferior fornix tear reservoir, where half the tear volume resides in healthy eyes. No amount of medication, supplements, or warm compresses will alleviate dry eye in the presence if this mechanical challenge.
I follow a two-pronged approach to the problem.
First, I surgically reconstruct the inferior fornix and tear reservoir.
Second, I start long-term therapy to control inflammation and dry eye disease. The result is relief from dry eye symptoms, including reduced inflammation that prevents conjunctivochalasis from reoccurring.
Dr. Desai is a consultant to Allergan, BioTissue, Lumenis, Johnson & Johnson Vision, and Shire.