A not uncommon, but usually misdiagnosed problem associated with obesity, goes by the wonderfully descriptive name “floppy eyelid syndrome”. The problem arises because in some obese patients the natural elasticity in the tissue of the upper eyelid is damaged. Instead of the usually quite firm structure, the eyelids do actually become “floppy”; it’s quite easy to invert them – to literally turn them inside out! In this situation the upper eyelid no longer fulfils its function of protecting the eye from the external environment. The eyes become dry and the patient complains of red, painful and watery eyes which may be difficult to open first thing in the morning. Infection can also occur with exacerbation of the symptoms.
Treatment is usually in the form of regular eye-drops to keep the eyes moist, with antibiotic drops if infection is present. It may also be helpful to tape the eyes shut at night to prevent the lids from opening during sleep. These simple measures usually do the trick, especially if the subject loses weight. In more persistent cases a small surgical procedure to tighten the lid (wedge resection) is usually effective.
Dr David Ashton
28th September 2010
