Dr Ben Wild
Overview |
The eyelids are made up of various types of skin, muscle, glands, hair follicles and much more. Their purpose is to protect the eyes from dryness, bright lights and irritants.
Frontal view of a healthy eye with minimal pressure being used to pull the upper eyelid upwards.
Floppy eyelid syndrome typically occurs unilaterally (in one eye) but can be bilateral (both eyes) and is usually seen in overweight males who sleep on their stomachs. This syndrome is characterized by the loss of upper eyelid muscles to the point where the eyelids can spontaneously flip upwards. Once flipped, usually occurring when the affected person is sleeping, the eyes remain exposed, can dry out, and can rub against a pillow thus damaging the inner eyelids and eye. This can lead to chronic eye infections.
Frontal view of an eye displaying floppy eyelid syndrome. The upper lid flips upwards with minimal pulling pressure.
Interestingly, this condition is highly associated with sleep apnea. The association is so strong that if someone is diagnosed with floppy eyelid syndrome, they should undergo sleep testing for sleep apnea. It is also associated, to a lesser extent, to cardiopulmonary disease.
Signs and Symptoms |
Signs
Extremely malleable upper eyelids, excess eyelid skin, large bumps on the inside of the upper eyelids and extreme ease when everting (flipping) eyelids.
Symptoms
Chronic discharge, dry eyes and discharge worse in the mornings, grittiness and burning of the eyes.
Causes and Risk Factors |
Causes
Loss of eyelid muscle.
Risk Factors
Being overweight, elderly, sleep apnea, cardiopulmonary disease and sleeping on stomach.
Prevention and Treatment |
Prevention
Sleep on sides or on back, treat sleep apnea, and weight control.
Treatments
· Lose weight.
· Artificial tears.
· Tape eyelids or wear an eye shield at night.
· Surgery.
Prognosis |
Surgery typically can dramatically reduce the number of times the eyelids flip but can lead to the loss of the ability to fully close the eyes on a normal eyelid blink. This can result in dry eyes which can be treated with artificial tears. If managed properly, there should be no permanent damage to the eyes or loss of vision.
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