The Relationship between Subjective Symptoms and Quality of Life in Conjunctivochalasis Patients.

Aoi Komuro,Hiroaki Kato,Chie Sotozono,Yukiko Sonomura,Shigeru Kinoshita,Norihiko Yokoi

doi:10.3390/diagnostics11020179

Aoi Komuro, Hiroaki Kato + Show 4 more

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https://doi.org/10.3390/diagnostics11020179

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Abstract

The purpose of this study was to evaluate the differences in subjective symptoms between patients with conjunctivochalasis (CCh) and dry eye (DE), and examine the relationship between subjective symptoms and quality of life (QOL). In 75 eyes of 75 CCh patients and 122 eyes of 122 DE patients, 12 subjective symptoms classified into four groups depending on the mechanisms associated with symptoms (ITF: instability of tear film, IF: increased friction, R: reflex, and DTC: delayed tear clearance) were evaluated by use of a visual analogue scale (VAS). Fifteen items related to DE symptoms and their influence on daily life were evaluated by use of the dry eye-related quality-of-life score (DEQS) questionnaire, with overall degree of QOL impairment calculated as a QOL score. The correlation between the Total VAS score and QOL score were evaluated. Between the CCh and DE patients, significant differences in subjective symptoms were found in eye dryness, pain, tearing sensitivity to light, and heavy eyelids, while tearing was higher in CCh. A significant strong correlation was found between QOL score and Total VAS score, ITF, and IF in CCh patients. The QOL of CCh patients is strongly determined by decreased tear-film stability and increased friction during blinking.

Highlights

Conjunctivochalasis (CCh) is a condition characterized by loose, redundant, binocular nonedematous conjunctival folds that occupy the lower tear meniscus [1,2]
Pascuale et al [7] reported that the subjective symptoms of a CCh patient were worsened by downgaze during reading or computer use and by vigorous blinking, while those of an aqueous deficient dry eye (DE) patient were worsened by upgaze due to increased interpalpebral exposure zone
Cases with DE accompanied by filamentary keratitis and/or superior limbic keratoconjunctivitis, or cases with symptoms that could be explained solely based on those abnormalities, were excluded from the analysis under a combined agreement of the evaluators (A.K., N.Y., H.K., and Y.S.), as the purpose of this study was to elucidate the relationship between CCh and DE in regard to subjective symptoms

Summary

Introduction

Conjunctivochalasis (CCh) is a condition characterized by loose, redundant, binocular nonedematous conjunctival folds that occupy the lower tear meniscus [1,2]. The subjective symptoms of CCh vary, since CCh causes precorneal tear film instability, increases the mechanical friction during blinking, and decreases tear flow at the lower tear meniscus [2,4,5,6]. There are four major mechanisms of ocular surface abnormalities, such as tear film instability, increased friction, reflex, and delayed tear clearance, and they can cause various DE-related subjective symptoms. Those mechanisms may be involved in the subjective symptoms of CCh, since they are similar to those of DE.

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