Which statement about floppy eyelid syndrome is true?

• A. It is unrelated to sleep apnea
• B. It is commonly associated with sleep apnea; management includes daytime PFATs, nighttime ointment, a sleeping mask, and sleep apnea evaluation
• C. It is an infectious eye disease
• D. It always requires surgical correction

Answer: (B)

Floppy eyelid syndrome involves marked laxity of the upper eyelid, so it easily everts and causes chronic mechanical irritation of the ocular surface. It commonly occurs with obesity and is strongly linked to obstructive sleep apnea. Because of this link, management targets both the eye surface and the sleep-disordered breathing. Daytime use of preservative-free artificial tears helps keep the cornea and conjunctiva lubricated and protected from exposure, while a nighttime lubricating ointment reduces surface irritation during sleep. A sleeping mask can help minimize eyelid trauma and exposure overnight, and evaluating for sleep apnea is important given the high association. Surgical lid tightening or other procedures are not universally required; they’re considered only if conservative measures fail or the eyelid laxity is severe.