Image Challenge of the Week!

The following patient with chronic papillary conjunctivitis presents with the shown exam finding. What is the condition and for what condition should these patients be screened?

floppy eyelid
BMJ Case Rep. 2015 Jul 2;2015

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Answer:

Floppy eyelid syndrome; obstructive sleep apnea

Discussion:

Floppy eyelid syndrome is a condition characterized by eyelid hyperlaxity (e.g. rubbery, easily everted upper eyelids or eyelash ptosis) and papillary conjunctivitis.

eyelash ptosis
Arch Ophthalmol. 2007;125(12):1613-1615

It is strongly associated with obstructive sleep apnea. Thus, such patients should be screened for obstructive sleep apnea and referred to a sleep disorder unit if positive.