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Conjunctivochalasis as a Contributing Factor for the Development of Ocular Surface Disease in Medically Treated Glaucoma Patients

Kocabeyoglu, Sibel MD; Mocan, Mehmet C. MD; Irkec, Murat MD; Orhan, Mehmet MD; Karakaya, Jale

doi: 10.1097/IJG.0b013e3182741f32
Original Studies

Purpose: To evaluate the impact of conjunctivochalasis (CCh) and its severity on the ocular surface parameters of glaucoma subjects treated with topical antiglaucomatous medication.

Materials and Methods: One hundred patients with the clinical diagnosis of glaucoma were recruited for this study. CCh was graded based on the extent of inferior lid margin involvement as follows: 1=single (temporal) location, 2=two locations (nasal and temporal), and 3=whole lid. For all the subjects, the break-up time (BUT), lissamine green (LG) staining, and Schirmer test (under topical anesthesia) was performed for both eyes. Ocular Surface Disease Index (OSDI) questionnaire scores were also noted for each subject. Student t test, Mann-Whitney U test, and Kruskal-Wallis test was used for statistical evaluations.

Results: Sixty-three subjects had evidence of CCh; 32 had grade 1, 24 had grade 2, 7 had grade 3 CCh, and 37 glaucoma patients had no evidence of CCh. There were significant differences in the BUT scores (7.2±2.7 vs. 10.1±2.4 s, P<0.001), Schirmer values (7.7±3.9 vs. 13.3.±4.0 mm, P<0.001), LG staining score (1.6±1.0 vs. 0.3±0.5, P<0.001), and the OSDI scores (19.4±17.2 vs. 6.7±5.2, P<0.001) between patients who had CCh and those without CCh. The BUT scores and Schirmer test values of patients with grades 2 and 3 CCh were significantly lower than those of grade 1 CCh and those without CCh (P<0.001). The LG grading and OSDI scores were significantly higher in grade 2 and 3 patients as compared with those with grade 1 CCh and those without CCh (P<0.001).

Conclusions: The functional characteristics of the ocular surface appear to be adversely influenced by the presence and the extent of CCh in glaucoma patients.

Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey

Disclosure: The authors declare no conflict of interest.

Reprints: Murat Irkec, MD, Department of Ophthalmology, Hacettepe University School of Medicine, 06100 Ankara, Turkey (e-mail:

Received April 13, 2012

Accepted August 28, 2012

© 2014 by Lippincott Williams & Wilkins.