Floppy eyelid syndrome can cause chronic eye discomfort in one or both eyes. A number of factors appear to work together to cause floppy eyelid syndrome, which can affect young children as well as adults. Floppy eyelid syndrome can lead to eye damage if not treated and can also indicate the presence of more serious disease.
A person who develops floppy eyelid syndrome has a decreased amount of elastin in the upper eyelid. Elastin helps keep tissues taut and firm. Abnormalities in the meibomian gland, which supplies oil as part of the tear film in the eye, also contribute to floppy eyelid syndrome. Blepharochalasis -- chronic eyelid swelling, or edema--may also play a part in floppy eyelid syndrome by leading to thinning of the skin, development of small broken blood vessels and relaxation of the tendon that helps elevate the upper eyelid, the levator aponeurosis.
A floppy upper eyelid is easily everted, or turned upward. The affected eye may also develop chronic irritation, dryness, redness, itching and mucousy discharge, particularly in the morning. The eyelid may droop and fall over the lower lid when the eyes close, a condition known as imbrication. Eyelashes may turn inward and rub against the eye, irritating and possibly damaging the cornea. Erosion of the cornea can lead to vision loss.
More men than women develop floppy eyelid syndrome, most often occurring in obese middle age people. Many people with floppy eyelid syndrome habitually sleep on the same side or with their face turned into the bed or pillow. The contact with the pillow may cause chronic irritation that leads to the symptoms associated with the condition. Obstructive sleep apnea, which results in multiple periods where no breathing occurs every night, also appears to increase the risk of floppy eyelid syndrome.
Covering the eye during the night to protect it from irritation or taping it shut helps prevent damage to the surface of the eye and chronic irritation. The diagnosis of floppy eyelid syndrome should also lead to sleep studies to test for obstructive sleep apnea. Artificial tear use during the day and before bed decreases discomfort and also makes the eye less prone to injury. Weight loss and treatment for sleep apnea also help reduce the risk of floppy eyelid syndrome. Surgical tightening of the eyelid may become necessary in some cases.
Floppy eyelid syndrome in and of itself can damage the surface of the eye, but it also points to the possibility of obstructive sleep apnea, a potentially serious condition. Obstructive sleep apnea increases the risk of heart attack, stroke, congestive heart failure, heart arrhythmias as well as glaucoma, elevated eye pressure that can lead to vision loss from damage to the optic nerve.