This Overlooked Condition Is Destroying Your Eyes

Added: 2026-05-12

[00:00:00]This might be a huge contributor to dry eye  or eye irritation that a lot of doctors are either brushing off or completely misdiagnose.  This is called conjuctibalis. So, we're going to go over exactly what this is, how you get it, and  ultimately how you can get rid of this. Going over the anatomy, the eyeball and inner layer of the  eyelid is aligned with this clear tissue called conjunctiva. And this might sound familiar.  If you get a conjunctivitis or a pink eye, it's usually the inflammation of that layer,  the conjuctiva. Now, normally this tissue is nice and clear and smooth and slippery. It's nice  and coated and so it doesn't have any really big friction between the eyelid and the eyeball. But  what can happen is that tissue can either become inflamed or develop kind of a loose redundant  tissue called conjuctctal folds. And when it does this, this extra loose redundant tissue  takes up the space between the eyelid and the eyeball where your tears usually are. And this is  actually very common to see in patients. A lot of times we see it in the inferior lower portion,  lower eyelid area. It can also happen under the top eyelid as well, just not as common. But  because this is considered a scenile change or a change that can naturally happen as we age,  sometimes it gets overlooked as being one of the significant contributors to ocular discomfort  or dry eyes. But depending on the severity, it can range from either people not even feeling  it, being completely asymptomatic to some people coming in and saying, "I feel like I have a  constant eyelash in my eye or something rubbing in my eye." Because a lot of that redundant tissue is  being rubbed and moved by the eyelid. Especially every time they blink, it can bump into that  tissue and it can drive some people bonkers. Now, there's a few ways that this specifically messes  with dry eyes. Now, normally the structure of the eyelid and the eyeball creates what's called a  tear meniscus or tear lake. This is where your natural tears kind of have a reservoir. You  can kind of think of it as a lake or a pool of tears that the eye can draw from to kind of  keep the eye coated with fresh tears. In fact, this is something that we can look for in a  dry eye evaluation. Kind of measure the tear lake volume or how much of a tear meniscus layer  a patient might have. And so when you get this redundant tissue, the conjuct hypocalis that takes  up the room, it's kind of like you are filling up the lake with dirt, rocks, and so there's not any  room for there to be a lake or a pond or water to fill in those areas. And number two, along the  same lines, because it's supposed to be nice and smooth, hardly any friction, the eyelids are  designed every time you blink to recoat the eyes with a fresh set of tears. When you have  that redundant tissue, it tends to mess up your blink. It doesn't have that nice smooth surface.  So, the tears get distributed unevenly. They get pushed around. Maybe some areas of the eye don't  get tears that coat the surface. And so a lot of times that patient will feel like their eyes water  all the time or just gets really irritated in the corner of the eyes. Now the exact cause, the exact  pathogenesis to this is not really fully known or fully understood. Now like I said, it's definitely  linked with the natural aging process over time.

[00:03:29]A lot of the structure and tissue does get loose  inside the eye pretty much everywhere in the body.

[00:03:35]And so that structure does cause that little bit  of change and redundant tissue in there. Also over time people get exposed to more oxidative stress  and it leaves behind these inflammatory cytoines or inflammation cells that cause more inflammation  to that tissue or thickening of the tissue. Now like I said the main risk factors for getting  this the number one is age related just kind of a natural change to the eye. But here's a list of  other possible risk factors that might cause you to get this even earlier on in age. As you can  see, just kind of like the mechanical friction from blinking, how your eyelids are set. If  you do suffer from a lot of inflammation, ocular surface inflammation with mayomian gland  dysfunction or even if you are someone that has a delayed tar clearance, maybe you have a little  bit smaller of a puncta where the drain is for the tears and a lot of your tears do kind of  build up over time and a lot of those cytoines, inflammatory cells kind of build up onto the  surface of the tissue causing that inflammation.

[00:04:34]Now the thing that surprised me when I started  looking into some studies the prevalence rate even in the lower ages were higher way higher than I  initially thought. If you look at this chart this was from one study they found that by the time  of age 41 it was 90%. In fact in their 20s 60% of the people had conjuctal colossus. Now this can  range from mild to severe but way more prevalent in younger ages than I initially thought. Other  studies showed kind of similar things. Overall, I'd say the average if you're a 40 and above,  about 50%, one in two people had conjucibis in some form or another. It's found that it is  more prevalent in women and like I said, usually you find it on the inferior or lower eyelid. Most  commonly is temporal or outer corner of the eye.

[00:05:22]That's usually where I see it in patients. But  if you are unlucky and you get it in the nasal corner, the inner corner of the eyelid, that's  where people usually have the worst symptoms. Now, this might be something that you can go check  out right now in the mirror, it can sometimes be difficult to see just with your naked eye. It's a  lot easier obviously to see it under a microscope, but if you want to go look at it, if you look  at the mirror, you might see some redness or irritation in the corner. But if you really want  to check it out, take your phone, have someone take a picture or zoom in on your eye. Don't bring  the phone really close to your eye because that can mess with the focus. Bring the phone out and  use the zoom lens, maybe zoom three, and have them zoom in right on the corners of the eyes to see if  you can see if any of that redundant tissue. Okay, so now let's get into the treatment, the meat and  potatoes of why you probably continued watching this video. Usually, the first line of therapy is  to use preservative-free artificial tears. I know that's an answer that not a lot of people want to  hear because they're probably sick of eye drops, but using frequent use of artificial tears  multiple times during the day can limit the amount of friction from the eyelid and the  eyeball. It can calm inflammation down and overall help the surface of the eye if there  is tear disruption caused by the redundant tissue. Here's a few artificial tears that can  be good ones if you haven't tried them. Also, I'll put a list in the description if you want  to check those out as well. Another prescription treatment that you can get from your doctor is  anti-inflammatory eye drops, steroid eye drops to decrease the inflammation. Now, with these cases,  even with the prescription eye drops, you're trying to manage the symptoms, trying to make  it not get any worse, decrease the inflammation, but there is a good chance that it might come  back. It's not really curing the condition.

[00:07:06]Another one is considered an offlabel treatment.  So, this is something you definitely want to talk to your eye doctor about. But there are a lot of  people, a lot of doctors out there that will tell their patients to use Lumifi. Again, off label,  but Lumifi is an over-the-counter eye drop mainly for redness. It's designed mainly to reduce vessel  congestion, a lot of dilated, beefy blood vessels, and that's why it's considered a kind of get the  redness out type of drop. But a lot of doctors have found that it can tighten up the conjuctiva  a little bit enough to maybe reduce symptoms maybe in mild maybe moderate conjuctis. Now getting  into the procedures or surgeries that can treat conjuctibly probably the one that's been more  common and popular over many years is conjuctal cottery where they can cauterize the tissue to  remove that extra redundant tissue. When you look at the pictures and see the procedure, it seems  kind of barbaric, but the outcomes actually have been really good. Another few options are using  laserbased treatments. There's an argon laser can work really well. One that has been shown  to be really effective is a plasmabased laser that can really shrink the tissue. And then also  a near infrared wavelength type of laser treatment that has worked really well, can reduce the tissue  and has very minimal bleeding and recovery time is better with this as well. Another option is using  high frequency radio waves. So there's a high frequency radio wave electro surgery that they  can use to reduce that tissue as well. In fact, most patients that have this usually have a  resolution of conjuctivocalis within one month of the procedure. And it's also shown to be very  effective in people that have mild moderate maybe younger age conjuctis as well. Now another popular  surgical procedure is a conjuctal excision where they surgically remove that extra tissue. And  now an option is becoming popular is to suture an amniotic membrane over that excision point.  The amniotionic membrane supplies the tissue with rehealing factors, natural factors, makes the  healing process a lot better, more natural, more effective, and faster. So, if this is something  that you think that you might have, you're interested in it, definitely talk to your eye  doctor about it, see if they can kind of look for any signs of conjuctis cuz like I said, definitely  a common one that gets overlooked or brushed off or misdiagnosed. And I think we as doctors need  to be better just to highlight certain things that might be there in patients eyes. If you have any  questions, leave them in the comments. I'll try and answer the best I can. But definitely check  out the description. I'll put links to different ey drops and links to different research articles  so you can kind of learn more about this and maybe check out some different pictures of what this  might look like. Hope this helped. Stay focused.