Floppy Eyelid Syndrome

Aging has always and will always be a reason for our bodies to change. At first, we mature with deeper voices, body hair in males, and those attractive curves in females. The next step is not as welcome. Our hair gets gray or falls out, wrinkles appear, gravity takes control of various body parts and in some our eye lids become floppy.

The pathophysiology of floppy eye lids can become complex with multiple side affects. Studies have shown the main cause to be decreased elastin with in the Tarsal plate of the eye lids. Currently, the most common etiology appears to be chronic mechanical irritation, or eye rubbing of the lids. This over time, damages the internal components of the lids. In turn, this results in obstruction of the lacrimal ducts that drains the eye thus causing dry eyes and infections.

As the eye lids become floppy and loose, they tend to evert during sleep on their own exposing the eye to the environment. This results in conjunctival, and corneal abrasions, redness, and increased likelihood of infections. Incomplete blinking may result as a secondary sign and then decreased vision.

Management of this condition varies depending on the severity. At first, wearing eye shields in addition to ointment at bed time often decreased the symptoms. If the condition still worsens, then surgery is required to correct the problem. The newest technique involves the implantation of a wedge shaped material to stiffen up the lid. This replaces the damaged tarsal plate; the lid is then much more difficult to evert, and it remains in it’s original position. This must be performed by an experienced Oculoplastic surgeon.

In short, everything tends to loosen up as we get older, but if the eyelids do, they must be repaired. Otherwise, there will be severe complications that may be vision threatening.