Floppy Eyelid Syndrome and Obstructive Sleep Apnoea


Authors: M. Karhanová 1;  M. Hobzová 2;  K. Marešová 1
Authors‘ workplace: Oční klinika LF UP a FN, Olomouc, přednosta doc. MUDr. Jiří. Řehák, CSc. 1;  Klinika plicních nemocí a tuberkulózy LF UP a FN, Olomouc, přednosta prof. MUDr. Vítězslav Kolek, DrSc. 2
Published in: Čes. a slov. Oftal., 68, 2012, No. 1, p. 22-28
Category: Original Article

Overview

Floppy eyelid syndrome (FES) is a relatively rare condition of unknown aetiology, commonly described in association with other systemic conditions, particularly with obstructive sleep apnoea – OSA (the most frequent and most significant sleep-related breathing disorder in terms of morbidity and mortality). It is characterized by an extremely enlarged and floppy upper eyelid which can be very easily everted (often spontaneously during sleep). The laterality of the disease corresponds to the side the patient sleeps on. The patient may also present with upper lid ptosis, lash ptosis or trichiasis, lower lid ectropion, chronic papillary conjunctivitis, and chronic corneal disorders. The aim of this study is to report this syndrome, which is often overlooked in eye clinics, and to summarize our experience with its diagnosis and treatment. The correct and early diagnosis of FES may be a clue to the correct diagnosis of, at the time of FES diagnosis, unknown OSA.

Key words:
floppy eyelid syndrome, conjunctivitis, obstructive sleep apnoea, snoring


Sources

1. Alexandrakis, G., Tse, D.T., Chang, W.J.: Spontaneous globe luxation associated with floppy eyelid syndrome and shallow orbits. Arch Ophtalmol, 1999; 117: 138–139.

2. Barbé, F., Duran-Cantolla, J., Capote, F., et al.: Long-term effect of continuous positive airway pressure in hypertensive patients with sleep apnea, Am J Respir Crit Care Med, 2010; 181: 718–726.

3. Bendel, R.E., Kaplan, J., Heckman, M. et al.: Prevalence of glaucoma in patients with obstructive sleep apnoea – a crosssectional case-series. Eye, 2008; 22(9): 1105–9.

4. Bixler, E.O., Vgontas, A.N., Lin, H.M., et al.: Association of hypertension and sleep - disorder breathing. Arch Intern Med, 2000; 160: 2289–2295.

5. Bonsignore, M.R., Battaglia, S., Zito, A., et al.: Sleep apnoea and systemic hypertension. Eur Respir Mon, 2000; 50: 150–173.

6. Boulton, J.E., Sullivan, T.J.: Floppy eyelid syndrome and mental retardation, Ophthalmology, 2000; 107: 1989–91.

7. Boyle-Walker, M., Semes L.P., Clay, O.J., at al.: Sleep apnea syndrome represents a risk for glaucoma in a veterans’ affairs population, ISRN Ophthalmology, 2011; Article ID 920767, 5 s.

8. Bradley, T.G., Floras, J.S.: Obstructive sleep apnoea and its cardiovascular consequences. Lancet, 2009; 373: 82–93.

9. Culbertson, W.W., Ostler, H.B.: The floppy eyelid syndrome. Am J Ophthalmol, 1981; 92: 568–575.

10. Culbertson, W.W., Tseng, S.C.: Corneal disorders in floppy eyelid syndrome. Cornea, 1994; 13: 33–42.

11. De Sousa, A.G.P., Cercato, C., Mancini, M.C., et al.: Obesity and obstructive sleep apnea – hypopnea syndrome. Complications of obesity, Obes Rev, 2008; 9: 1–15.

12. Donnenfeld, E.D., Perry H.D., Gibralter, R.P., at al.: Keratoconus associated with floppy eyelid syndrome. Ophthalmology, 1991; 98(11): 1674–8.

13. Dufek, M.A., Schechtman, D.L.: Floppy eyelid syndrome: a diagnostic dilema. J Am Optom assoc, 1999; 70: 450–454.

14. Ezra D.G., Beaconsfield, M., Sira, C. et al.: Long-term outcomes of surgical approaches to the treatment of floppy eyelid syndrome. Ophthalmology, 2010; 117(4): 839–46.

15. Gerner, E.W., Hughes, S.M.: Floppy eyelid with hyperglycinemia. 1984; 98: 614-616.

16. Grote, L., Sommermayer, D.: Early atherosclerosis and cardiovascular events. Eur Respir Mon, 2010; 50: 174–188.

17. Haentjens, P., Van Meerhaeghe, A., Moscariello, A., et al. The impact of continuous positive airway pressure on blood pressure in patients with obstructive sleep apnea syndrome: evidence from a meta-analysis of placebo controlled randomized trials, Arch Intern Med, 2007; 167: 757–764.

18. Karger R.A., White, W.A., Park, W.C. et al.: Prevalence of floppy eyelid syndrome in obstructive sleep apnea-hypopnea syndrome, Ophthalmology, 2006; 113(9): 1669–74.

19. Klozar, J.: Jak odstranit chrápání?, Interní Med, 2011; 13(1), 51–53.

20. Lagford, J.D., Linberg, J.V.: A new physical finding in floppy eyelid syndrome. Ophtalmology, 1998; 105: 165-169.

21. Lam, J.C.M., Lui, M.M.S., Op, M.S.M.: Diabetes and metabolic aspects of OSA, Eur Respir Mon, 2010; 50: 189–215.

22. Liu, D.T., Pasculate, M.A., Sawai, J., et al.: Tear film dynamics in floppy eyelid syndrome. Invest Ophthalmol Vis Sci, 2005; 46: 1188–94.

23. Lopez, P.P., Stefan, B., Schulman, C.I.: Prevalence of sleep apnea in morbidity obese patients who presented for weight loss surgery evaluation: more evidence for rutine screening for obstructive sleep apnea before weight loss surgery. Am Surg, 2008; 74: 384–388.

24. Madjlessi, F., Kluppel, M., Sundmacher, R.: Die Operation des Floppy Eyelids. Klin Monatsbl Augenheilk, 2000; 216: 148–151.

25. Martinez-Garcia, M.A., Soler-Cataluna, J.J., Ejarque-Martinez, L., et al.: Continuous positive airway pressure treatment reduces mortality in patients with ischemic stroke and obstructive sleep apnea: a 5-year follow up study. Am J Respir Crit Care Med, 2009; 180: 36–41.

26. Mazal, Z.: The floppy eyelid syndrom. Čs Oftalmol, 1990; 46(6): 134–438.

27. Miyamoto, C., Santo, L., C., E., Roisman, L. et al.: Floppy eyelid syndrome: review. Arq. Bras. Oftalmol., 2011; 74 (1): 64–66.

28. McNab, A.A.: Floppy eyelid syndrome and obstructive sleep apnoe. Ophtal plast reconstr Surg, 1997; 13: 98–114.

29. McNab, A.A.: Reversal of floppy eyelid syndrome with treatment of obstructive sleep apnoea. Clin experiment Ophthalmol, 2000; 28: 125–6.

30. McNaab, A.A.: The eye and sleep, Clin Experiment Ophthalmol, 2005; 33(2): 117-25.

31. McNicholas, W.T., Bonsignore, M.R..: Sleep apnoea as an independent risk factor for cardiovascular disease: current evidence, basic mechanisms, and research priorities. Eur Respir J, 2007; 29: 156–178.

32. Nevšímalová, S., Šonka, K., et al.: Poruchy spánku a bdění, Praha, Galén, 2007; 345 s.

33. Parra, O., Arboix, A., Montserrat, J.M., et al.: Sleep related breasing disorders: impact on mortality of cerebrovascular disease, Eur Respir J, 2004; 24: 267–272.

34. Periman, L.M., Sires, B.S.: Floppy eyelid syndrome: a modified surgical technique. Ophthal Plast Reconstr Surg, 2002; 18: 370–372.

35. Riha, R.L.: Genetic aspects of obstructive sleep apnoea-hypopnoea syndrome. Somnologie, 2006; 10: 101–112.

36. Schlotzer-Schrehardt, U., Stojkovic, M., Hofmann-Rummelt, C., et al.: The pathogenesis of floppy eyelid syndrome: involvement and elastic fiber degradation. Ophthalmology, 2005; 112: 694–704.

37. Sergi, M., Salerno, D.E., Rizzi, M. et al.: Prevalence of normal tension glaucoma in obstructive sleep apnea syndrome patients. J Glaucoma, 2007; 16(1): 42–6.

38. Šonka, K., a kol.: Apnoe a další poruchy dýchání ve spánku. Praha, Grada, 2004; 247 s.

39. Tasali, E., Ip, MS.: Obstructive sleep apnea and metabolic syndrome: alterations inglucose metabolism and inflammation. Proc Am Thorac Soc, 2008; 15: 207–217

40. Tkáčová, R.: Spánkové apnoe a ochorenia kardiovaskulárného systému. Praha, Galén, 2006; 194.

41. Veale, D., Rabec, C., Labaan, J.P.: Respiratory complications in obesity. Breath, 2008; 4: 211–223.

42. Yaggi, H.K., Concato, J., Kernan, W.N., et al.: Obstructive sleep apnea as a risk factor for stroke and dech. N Engl J Med, 2005; 353: 2034–2041.

43. Ye, L., Pien, G.W., Weaver, T.E..: Gender differences in the clinical manifestation of obstructive sleep apnea. Sleep Med, 2009; 10: 1075–1084.

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Ophthalmology
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