Floppy Eyelid Syndrome
This 56 year old man suffered from many years of  recurrent mucous discharge in both eyes which was much worse in the left than the right eye. He had had treatment for possible allergic blepharoconjunctivitis including lid hygiene and various eyedrops without improvement of the symptoms. In his latest visit, he mentioned that the mucous discharge was worse in the morning and the left eye was always sore.  Examination revealed a left puffy eyelid and lash ptosis. Eversion of the left upper lid revealed papillary conjunctivitis and the presence of punctate keratitis. The left eyelid could also be easily everted. Further questioning revealed that the patient slept on his left side and the pillow was always stained with ocular discharge. A diagnosis of left floppy eyelid syndrome was made. He was advised to tape his left lid at bed time with significant improvement of the signs and symptoms.

Left puffy upper lid and eyelash ptosis.

The left upper lid can be easily everted with patient's index finger.

The right upper lid could not be everted with the patient's index finger.

 
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