An obese 45-year-old man has chronic bilateral papillary conjunctivitis unresponsive to standard allergy treatment. His upper lids are lax and evert spontaneously during sleep, with a rubbery tarsal plate. Which systemic condition is MOST classically associated?
- A Rheumatoid arthritis
- B Obstructive sleep apnoea ✓
- C Hyperthyroidism
- D Atopic dermatitis
Correct answer: B. Obstructive sleep apnoea
Explanation
Floppy eyelid syndrome features lax, rubbery upper tarsi that evert during sleep, allowing mechanical trauma against bedding and producing chronic papillary conjunctivitis. It is strongly associated with obstructive sleep apnoea and obesity, so affected patients should be screened for sleep apnoea. Rheumatoid arthritis is linked to dry eye and peripheral ulcerative keratitis, while atopy gives limbal or palpebral vernal-type changes without spontaneous lid eversion.
Reference: Kanski's Clinical Ophthalmology, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.