Floppy eyelid syndrome: ocular and systemic associations

Area of Science:

• Ophthalmology
• Sleep Medicine
• Genetics

Background:

• Floppy eyelid syndrome (FES) is characterized by excessive eyelid laxity.
• FES is frequently associated with other systemic and ocular conditions.

Purpose of the Study:

• To review the ocular and systemic associations of FES.
• To update knowledge on FES pathogenesis and treatment.

Main Methods:

• Literature review of studies on FES associations, pathogenesis, and treatment.
• Analysis of shared pathophysiological mechanisms.

Main Results:

• Nearly all FES patients have obstructive sleep apnea (OSA), though the reverse is less common.
• FES is also associated with keratoconus (KCN) and glaucoma.
• Common findings include decreased corneal hysteresis and matrix metalloproteinase (MMP) upregulation, suggesting shared pathogenesis.

Conclusions:

• FES, OSA, glaucoma, and KCN share potential common pathophysiological mechanisms.
• Management of FES should include screening for OSA.
• Potential future treatments may involve stabilizing tarsal tissues.