Saturday, December 13, 2008

Floppy Eyelid Syndrome

You're probably thinking well shoot, I've already got that. You may well have saggy eyelid syndrome--you know, look in the mirror, gently shove the skin below your eyebrows off your upper lids and poof, the young, wide-eyed ingenue reappears. But this is FLOPPY Eyelid Syndrome, first described in 1981 by two researchers checking out the lids on middle-aged obese men. Associated with sleep apnea, this lizardish look not only includes the saggy lidded thing but also redness and irritation in the no-longer-so whites of the eyes.

We know that sleep apnea can seriously affect the heart (right-sided failure) and brain (increased risk of small vessel disease and 'mini' strokes). But why the eyes? Some investigators feel the cause is mechanical stress--i.e. smashing and stretching the eye against pillow--which is supported by the fact that one-sided sleepers often get one-sided F.E.S. Others wonder if alternating ischemia (not enough oxygenated blood) followed by reperfusion (flood of oxygen-rich blood when the apnea ceases) results in tissue inflammation. Studies of floppy lids (what happened to the sleeper upon which these lids resided!?!) showed an inflammatory injury reaction consistent with both stress and ischemia as seen in other tissue types.

Not only does F.E.S. limit the field of vision (while providing, perhaps, some sun protection in a visor sort of way), but the redness and irritation along with that iguana image may necessitate a surgical lid lift, one that the insurance company would be willing to fund!


kenju said...

I wish the insurance company would fund the other kind! My lids lay on my lashes sometimes, and it feels like my lids are swollen.

Ruth said...

The peripheral vision of older drivers can be affected by this condition increasing risks on the road. I don't even like to contemplate some of the effects of ageing.

Mauigirl said...

One of my eyelids is droopier than the other - no, no myasthenia gravis, of course I had to run off and get tested for that. Maybe this is what it is???