The Influence of Lid-Parallel Conjunctival Folds and Conjunctivochalasis on Dry Eye Symptoms with and Without Contact Lens Wear: A Review of the Literature

Antonio Ballesteros-Sánchez; José-María Sánchez-González; María Agustina Borrone; Davide Borroni; Carlos Rocha-de-Lossada

doi:10.1007/s40123-023-00877-9

The Influence of Lid-Parallel Conjunctival Folds and Conjunctivochalasis on Dry Eye Symptoms with and Without Contact Lens Wear: A Review of the Literature

Ophthalmol Ther. 2024 Mar;13(3):651-670. doi: 10.1007/s40123-023-00877-9. Epub 2024 Jan 13.

Authors

Antonio Ballesteros-Sánchez^{1

2}, José-María Sánchez-González³, María Agustina Borrone⁴, Davide Borroni^{5

6}, Carlos Rocha-de-Lossada^{7

8

9

10}

Affiliations

¹ Department of Physics of Condensed Matter, Optics Area, University of Seville, Reina Mercedes Street, Seville, Spain. antbalsan@alum.us.es.
² Department of Ophthalmology, Clínica Novovisión, Murcia, Spain. antbalsan@alum.us.es.
³ Department of Physics of Condensed Matter, Optics Area, University of Seville, Reina Mercedes Street, Seville, Spain.
⁴ Department of Ophthalmology, Hospital General de Agudos Dr Ignacio Pirovano, Buenos Aires, Argentina.
⁵ Department of Doctoral Studies, Riga Stradins University, Riga, 1007, Latvia.
⁶ Advalia Vision, Cornea Research Unit, 20145, Milan, Italy.
⁷ Qvision, Ophthalmology Department, VITHAS Almeria Hospital, 04120, Almeria, Spain.
⁸ Ophthalmology Department, VITHAS Malaga, 29016, Malaga, Spain.
⁹ Regional University Hospital of Malaga, Hospital Civil Square, 29009, Malaga, Spain.
¹⁰ Surgery Department, Ophthalmology Area, University of Seville, Doctor Fedriani, 41009, Seville, Spain.

Abstract

Introduction: Lid-parallel conjunctival folds (LIPCOF) and conjunctivochalasis (CCH) are similar conditions that seem to be related to dry eye severity. In addition, there is a lack of studies on the topic of LIPCOF and CCH on dry eye symptoms in non-contact lens and contact lens (CL) wearers. Therefore, the aim of this study is to review the relationship of LIPCOF and CCH with dry eye symptoms in non-CL and CL wearers, as well as to report the treatment of dry eye disease (DED) in non-CL and CL wearers who present LIPCOF or CCH.

Methods: A literature review of full-length original studies in two databases, PubMed and Scopus, was performed. The search period included observational studies in humans published between April 21, 2009 and March 20, 2023.

Results: A total of 26 studies were included. The studies suggest that LIPCOF and CCH are significantly related to dry eye symptoms in non-CL and CL wearers. However, the impact of CL wear on LIPCOF and CCH may be complex and may vary depending on individual factors such as lens type, lens care regimen, and pre-existing ocular conditions. Regarding LIPCOF management, tear substitutes seem to significantly reduce LIPCOF and dry eye symptoms in non-CL wearers, while vectored thermal pulsation (VTP) and microblepharoexfoliation (MBE) are suggested as promising treatment for LIPCOF and dry eye symptoms in CL wearers. Regarding CCH management, surgical interventions may be effective in reducing CCH when medical treatments have no response. In addition, an ocular examination by slit lamp is necessary to distinguish both conditions.

Conclusions: Tear substitutes, VTP, MBE, and fitting CLs with low coefficient of friction (CoF) seem to reduce and prevent LIPCOF. However, surgical treatment options seem to be more effective in the complete elimination of CCH. An adequate evaluation and differentiation between LIPCOF and CCH are important, and they should be considered by practitioners in managing dry eye symptoms in non-CL and CL wearers.

Keywords: Conjunctivochalasis; Contact lens wearers; Dry eye symptoms; Lid-parallel conjunctival folds.

Publication types

Review