Eyelid getting irritated when you sleep
A patient came to my office today and presented with a drooping eyelid. He felt the eyelid got irritated when he slept and sometimes he would wake up with discharge, irritation and a feeling of something in his eye.
On examination his eyelid was drooping and the lashes of his eyelid was turning down. This is called lash ptosis and it was even seen on his good eye. When I stretched the eyelid his eyelid was very loose or floppy.
Diagnosis: Floppy Eyelid Disease
The patient has floppy eyelid disease which is looseness of the eyelid. Patients with this disease have a 96% chance of having sleep apnea. Obstructive sleep apnea is a obstructive condition where patients’ soft tissue collapses when they sleep causing their airway to close so they don’t get oxygen. This is referred to as hypoxia (hyp – not enough, oxia – oxygen). It can cause heart failure, stroke, and is even linked to cancer.
Patients with floppy eyelid often can get their eyelid tightened to raise their eyelid but the big thing for them is treatment for the floppy eyelid syndrome and sleep apnea. Usually this involves a sleep workup which is testing of oxygen levels in patients as they are sleeping. Sleep apnea is treated with CPAP or air that blown into the throat during sleep so oxygen levels are normal. Many sleep apnea patients I have seen will tell me that once they started CPAP they have slept “like they did when they were a kid”.
The three components of floppy eyelid that slam dunk the diagnosis are
Lashes pointed down
Looseness of the eyelid
Floppy eyelid associated with sleep apnea can also be related to other eye diseases which include
Optic Nerve strokes
Central Serous Chorioretinopathy
Floppy eyelid disease is one where a patient should get it checked out as soon as possible for the eyelid but more importantly so they can be tested for sleep apnea.
Symptomwise, patients often complain of
Eyelid irritation on waking
Sleeping on the side of the worse eyelid
Discharge in the morning from the eyelid
Floppy eyelid is treated with tightening the eyelids usually through incisions that are made on the side to reduce the looseness of the eyelid. This is done as an outpatient with twilight sedation. For a floppy eyelid evaluation contact our office at 303 468 8844.