Conjunctivochalasis, like aqueous tear deficiency and evaporative dry eye, puts stress on the meibomian glands because there can be excessive friction during each blink. Stressed meibomian glands produce poor quality meibum because the cells that turn into meibum are in an inflamed state when they die off.
Conjunctivochalasis also interferes with proper tear film distribution over the eye surface.
Conjunctivochalasis is both caused by Dry Eye and causes or exacerbates Dry Eye.
The impact of conjunctivochalasis on dry eye symptoms and signs
Chhadva P, Alexander A, McClellan AL, McManus KT, Seiden B, Galor A.
Investigative Ophthalmology & Visual Science
2015 May;56(5):2867-71. doi: 10.1167/iovs.14-16337.
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