Welcome to Review of Optometry's Practice Pearl of the Week series. Optometrist Paul Karpecki will provide you invaluable clinical information and management strategies for a host of ocular conditions—from dry eye and corneal infection to retinal artery occlusion and neuro-ophthalmic disease.

You will always impress your patients when you uncover and diagnose systemic diseases based on ocular findings. As such, if you confirm a diagnosis of conjunctivochalasis, you might also be able to identify coexistent thyroid eye disease. One prospective study published in the August 2006 issue of Cornea documented that as many as 88% of patients with conjunctivochalasis also have autoimmune thyroid eye disease.¹

Risk factors for conjunctivochalasis include advanced age (older than 50 years), prior ocular surgery, previous incidences of inflammatory ocular surface disease, and a history of conjunctival chemosis.² It should be noted that conjunctival chemosis might occur secondary to long-standing allergic conjunctivitis, dry eye, trauma or inflammatory conditions, such as episcleritis.³

So, it is imperative to educate your patients about the rather prevalent association between conjunctivochalasis and thyroid eye disease. Be certain that an internist or endocrinologist initiate a confirmatory diagnosis and subsequent systemic management.

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