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Chan JS, Lee MK, Tweedie PJ, Tiong CJ, Tsoi AT, Vasanthan A, Maegraith J, Borchert GA, Gunasegaram JR, Waldie AM, Wilcsek G, Francis IC. Observations on the association between obstructive sleep apnea and floppy eyelid syndrome: A systematic review and meta-analysis. Surv Ophthalmol 2024; 69:291-292. [PMID: 37813126 DOI: 10.1016/j.survophthal.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 09/29/2023] [Accepted: 10/03/2023] [Indexed: 10/11/2023]
Affiliation(s)
- Jian S Chan
- Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Matthew K Lee
- Department of Ophthalmology, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Peter J Tweedie
- Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Claudia J Tiong
- School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
| | - Amy T Tsoi
- Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Aadhavi Vasanthan
- Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Jed Maegraith
- Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Grace A Borchert
- Nuffield Laboratory of Ophthalmology, Department of Clinical Neurosciences, Oxford University, Oxford, United Kingdom
| | - James R Gunasegaram
- Faculty of Medicine, Nursing, and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Anna M Waldie
- Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia; Department of Ophthalmology, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Geoff Wilcsek
- Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia; Department of Ophthalmology, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Ian C Francis
- Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia; Department of Ophthalmology, Prince of Wales Hospital, Sydney, New South Wales, Australia.
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De Gregorio A, Cerini A, Scala A, Lambiase A, Pedrotti E, Morselli S. Floppy eyelid, an under-diagnosed syndrome: a review of demographics, pathogenesis, and treatment. Ther Adv Ophthalmol 2021; 13:25158414211059247. [PMID: 35187400 PMCID: PMC8855428 DOI: 10.1177/25158414211059247] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 10/25/2021] [Indexed: 12/04/2022] Open
Abstract
Floppy eyelid syndrome (FES) is a frequent eyelid disorder characterized by eyelid laxity that determines a spontaneous eyelid eversion during sleep associated with chronic papillary conjunctivitis and systemic diseases. FES is an under-diagnosed syndrome for the inaccuracy of definition and the lack of diagnostic criteria. Eyelid laxity can result from a number of involutional, local, and systemic diseases. Thus, it is pivotal to use the right terminology. When the increased distractibility of the upper or lower eyelid is an isolated condition, it is defined as ‘lax eyelid condition’ (LAC). When laxity is associated with ocular surface disorder such as papillary conjunctivitis and dry eyes, it can be referred to as ‘lax eyelid syndrome’ (LES). However, FES is characterized by the finding of a very loose upper eyelid which everts very easily and papillary tarsal conjunctivitis affecting a specific population of patients, typically male, of middle age and overweight. Obesity in middle-aged male is also recognized as the strongest risk factor in obstructive sleep apnea-hypopnea syndrome, (OSAHS). FES has been reported as the most frequent ocular disorder associated with OSAHS. Patients with FES often complain of non-pathognomonic ocular signs and symptoms such as pain, foreign body sensation, redness, photophobia, and lacrimation. Due to these clinical features, FES is often misdiagnosed while an early recognition might be important to avoid its chronic, distressing course and the associated morbidities. This review provides an updated overview on FES by describing the epidemiology, proposed pathogenesis, clinical manifestations, related ocular, and systemic diseases, and treatment options.
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Affiliation(s)
- Alessandra De Gregorio
- Ophthalmic Unit, San Bassiano Hospital, Via dei Lotti 40, 36061 Bassano del Grappa, Vicenza, Italy
| | - Alberto Cerini
- Eye Clinic, Department of Sense Organs, Umberto I Policlinico, Sapienza University of Rome, Rome, Italy
| | - Andrea Scala
- Ophthalmic Unit, San Bassiano Hospital, Bassano Del Grappa, Italy
| | - Alessandro Lambiase
- Eye Clinic, Department of Sense Organs, Umberto I Policlinico, Sapienza University of Rome, Rome, Italy
| | - Emilio Pedrotti
- Eye Clinic, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
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