Most often, he has discovered sleep apnea when one of his patients is sedated for surgery, but less often he sees an eye disorder that is almost always associated with sleep apnea, called floppy eye syndrome.
What is floppy eyelid syndrome?
Floppy eyelid syndrome (FES) is an eye disorder that is under-diagnosed. Symptoms include irritation and itching of they eyes, especially upon waking.
The disorder is characterized by the eyelids becoming loose and rubbery and easily flipping over, like when rolling over in bed and the eyelid comes in contact with the pillow.
Who gets floppy eyelid syndrome?
It is most common in overweight, middle-aged men, similar to sleep apnea (learn more about risk factors for sleep apnea here).
It is associated with keratoconus (visual distortions like ghosting, multiple images, glare, halos, or blurred vision) and lash ptosis (eyelashes that point out from the eye horizontally or downward).
How is floppy eyelid syndrome related to sleep apnea?
A 2010 study looked at 102 patients with FES and a control group of another 102 patients. 90% of study participants with FES also had obstructive sleep apnea.
A 2012 study of 127 people suspected of having obstructive sleep apnea found that 25.8% of those with OSA also had FES and of those with more severe OSA (AHI over 30, learn about AHI here), 40% had FES. The researchers concluded that severe OSA may be an independent risk factor for FES.
Researchers aren’t exactly sure why. In addition to shared risk factors (obesity, age), it could be that those with OSA have greater tissue elasticity which also affects incidence of FES,
According to Dr. Brad Sutton, OD, FAAO, of the Indiana University School of Optometry, “The incidence of sleep apnea in patients with floppy eyelid syndrome (FES) is essentially 100%.”
Dr. Sutton urges his patients with FES to get tested for sleep apnea.
How is floppy eye syndrome treated?
FES is often treated as eye irritation with drops before the patients are properly diagnosed. However, finding out if the patient has sleep apnea and then treating the sleep apnea is the best approach as this will likely improve the FES.
Dr. Sutton’s treatment approach is three parts:
- Using a thick lubricating ointment at night.
- Sleeping with a cylindrical pillow to minimize contact with the eye and the pillow at night.
- Wearing a firm sleep mask or taping the eyelids down to prevent eversion (flipping).
If those treatments don’t work, surgery to tighten the eyelid tissue may be required.
If you or a loved one suffers from floppy eye syndrome, talk to your doctor. If you suspect that you suffer from sleep apnea, we can help.
- Chambe, Juliette, et al. “Floppy eyelid syndrome is associated with obstructive sleep apnoea: a prospective study on 127 patients.” Journal of sleep research 21.3 (2012): 308-315.
- Ezra, Daniel G., et al. “The associations of floppy eyelid syndrome: a case control study.” Ophthalmology117.4 (2010): 831-838.
Other posts you may find interesting:
orthea harcumPosted on January 16, 2019
i have floppy eyelids i use a cpap
Bev TidingPosted on January 20, 2019
Seems like plastic surgeons who are frequently sought out for upper blepharoplasties should be strongly counseling these patients to have OSA testing.
Gibson.BaronPosted on July 10, 2020
A long way, you can finish step by step, and then you can’t reach without a foot
NickPosted on May 24, 2021
I think you should go back to your private chat with Joe Biden.
scott tuleyPosted on April 23, 2021
Hi guys, does anyone know of any places that treat the floppy eyelid condition as in surgery? I have it myself due to my sleep apnea! Thanx
Michele SeverinoPosted on May 04, 2021
I am having surgery on both eyes this Thursday. My FES is due to my genetic condition called Ehlers Danlos Syndrome. Lower lid and upper lid tightened and blepharoplasties on hooding. Insurance is covering the FES surgery, paying out of pocket for the blepharoplasties.
Health BlogsPosted on July 31, 2021
Awesome blog. Keep writing.
Fitness ArticlesPosted on August 04, 2021
Very informative blog. Thank you.
robbie GareauPosted on October 12, 2021
where can I get a firm sleeping eye mask for floppy eyelid syndrome and a cylindrical pillow for floppy eyelid syndrome? I have floppy eyelid syndrome in my left eye from pulling and streteching my upper left eyelid and my left eye allow feel so dry and uncomfortable and I put artificial tears and rewetting eye drops in both my eyes but more in my left eye than right eye
SomeonePosted on August 05, 2022
Seems pretty obvious to me, the same underlying disorders causing muscular slack, low energy, and a weakening and atrophying of the body in general are causing both the eyelid issues and the apnea.. along with the obesity, face puffiness, etc.
and if we could get endocrinologists to listen and actually deal with our obvious-symptom problems, instead of saying we must be fine because we scored the lowest possible hormone levels you can while still being in the “healthy range,” maybe we could solve these problems.
ConcernedPosted on February 02, 2023
Only started getting sagging eyelids after using cpap. How to fix it?