A patient with long-standing floppy eyelid syndrome (FES) is most likely to have which associated systemic condition that requires evaluation?

• A Systemic arterial hypertension
• B Hypothyroidism causing periorbital oedema
• C Type 2 diabetes mellitus
• D Obstructive sleep apnoea (OSA) ✓

Explanation

Floppy eyelid syndrome is characterised by lax, easily everted upper lids and papillary conjunctivitis, caused by loss of tarsal elastin fibres. It is strongly associated with obstructive sleep apnoea (OSA) due to shared pathomechanisms: repetitive mechanical rubbing of the lid against the pillow during sleep (eye lid eversion during apnoeic episodes with body movements) and possible systemic elastin degradation from chronic hypoxia and oxidative stress. Studies show FES patients have 50–80% prevalence of OSA. All patients with FES should undergo polysomnography and CPAP therapy improves both OSA and ocular surface disease.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.