Floppy eyelid syndrome: a diagnostic dilemma.

Background: Floppy eyelid syndrome may be the underlining cause of papillary keratoconjunctivitis. Patients initially report a nonspecific irritation, redness, or a foreign body sensation.

Methods: As a result of its vague presentation, floppy eyelid syndrome is frequently misdiagnosed. A careful slit-lamp evaluation and a complete history aids in the diagnosis.

Conclusions: The most distinctive feature of floppy eye syndrome is a pliant upper tarsus that is easily everted without excess manipulation. Histopathology has attributed the laxity of the lid to a decreased amount of elastin within the tarsus. Treatment includes prevention of the upper lid from everting during sleep or surgical procedures such as horizontal eyelid shortening. Our case report illustrates a patient with a classic case of floppy eyelid syndrome.