<?xml version="1.0" encoding="UTF-8"?>
<article article-type="research-article" dtd-version="1.3" xml:lang="en">
  <front>
    <journal-meta>
      <journal-title-group>
        <journal-title>Czech and Slovak Ophthalmology</journal-title>
      </journal-title-group>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="publisher-id">387</article-id>
      <article-categories>
        <subj-group>
          <subject>Review</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>Floppy Eyelid Syndrome and Obstructive Sleep Apnoea</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <name>
            <surname>Karhanová</surname>
            <given-names>Marta</given-names>
          </name>
          <contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0879-3055</contrib-id>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Hobzová</surname>
            <given-names>Milada</given-names>
          </name>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Marešová</surname>
            <given-names>Klára</given-names>
          </name>
          <contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9973-3145</contrib-id>
        </contrib>
      </contrib-group>
      <pub-date date-type="pub" publication-format="electronic">
        <day>10</day>
        <month>2</month>
        <year>2012</year>
      </pub-date>
      <issue>1</issue>
      <elocation-id>4</elocation-id>
      <abstract>
        <p>Floppy eyelid syndrome (FES) is a relatively rare condition of unknown aetiology, commonly described in association with other systemic conditions, particularly with obstructive sleep apnoea – OSA (the most frequent and most significant sleep-related breathing disorder in terms of morbidity and mortality). It is characterized by an extremely enlarged and floppy upper eyelid which can be very easily everted (often spontaneously during sleep). The laterality of the disease corresponds to the side the patient sleeps on. The patient may also present with upper lid ptosis, lash ptosis or trichiasis, lower lid ectropion, chronic papillary conjunctivitis, and chronic corneal disorders. The aim of this study is to report this syndrome, which is often overlooked in eye clinics, and to summarize our experience with its diagnosis and treatment. The correct and early diagnosis of FES</p>
      </abstract>
      <kwd-group>
        <kwd>floppy eyelid syndrome</kwd>
        <kwd>conjunctivitis</kwd>
        <kwd>obstructive sleep apnoea</kwd>
        <kwd>snoring</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <back>
    <ref-list>
      <title>References</title>
      <ref id="R12240">
        <mixed-citation>Alexandrakis, G., Tse, D.T., Chang, W.J.: Spontaneous globe luxation associated with floppy eyelid syndrome and shallow orbits. Arch Ophtalmol, 1999; 117: 138–139.</mixed-citation>
      </ref>
      <ref id="R12241">
        <mixed-citation>Barbé, F., Duran-Cantolla, J., Capote, F., et al.: Long-term effect of continuous positive airway pressure in hypertensive patients with sleep apnea, Am J Respir Crit Care Med, 2010; 181: 718–726.</mixed-citation>
      </ref>
      <ref id="R12242">
        <mixed-citation>Bendel, R.E., Kaplan, J., Heckman, M. et al.: Prevalence of glaucoma in patients with obstructive sleep apnoea – a crosssectional case-series. Eye, 2008; 22(9): 1105–9.</mixed-citation>
      </ref>
      <ref id="R12243">
        <mixed-citation>Bixler, E.O.,Vgontas, A.N., Lin, H.M., et al.: Association of hypertension and sleep - disorder breathing. Arch Intern Med, 2000; 160: 2289–2295.</mixed-citation>
      </ref>
      <ref id="R12244">
        <mixed-citation>Bonsignore, M.R., Battaglia, S., Zito, A., et al.: Sleep apnoea and systemic hypertension. Eur Respir Mon, 2000; 50: 150–173.</mixed-citation>
      </ref>
      <ref id="R12245">
        <mixed-citation>Boulton, J.E., Sullivan, T.J.: Floppy eyelid syndrome and mental retardation, Ophthalmology, 2000; 107: 1989–91.</mixed-citation>
      </ref>
      <ref id="R12246">
        <mixed-citation>Boyle-Walker, M., Semes L.P., Clay,O.J., at al.: Sleep apnea syndrome represents a risk for glaucoma in a veterans’ affairs population, ISRN Ophthalmology, 2011; Article ID 920767, 5 s.</mixed-citation>
      </ref>
      <ref id="R12247">
        <mixed-citation>Bradley, T.G., Floras, J.S.: Obstructive sleep apnoea and its cardiovascular consequences. Lancet, 2009; 373: 82–93.</mixed-citation>
      </ref>
      <ref id="R12248">
        <mixed-citation>Culbertson, W.W., Ostler, H.B.: The floppy eyelid syndrome. Am J Ophthalmol, 1981; 92: 568–575.</mixed-citation>
      </ref>
      <ref id="R12249">
        <mixed-citation>Culbertson,W.W., Tseng, S.C.: Corneal disorders in floppy eyelid syndrome. Cornea, 1994; 13: 33–42.</mixed-citation>
      </ref>
      <ref id="R12250">
        <mixed-citation>De Sousa, A.G.P., Cercato, C., Mancini, M.C., et al.: Obesity and obstructive sleep apnea – hypopnea syndrome. Complications of obesity, Obes Rev, 2008; 9: 1–15.</mixed-citation>
      </ref>
      <ref id="R12251">
        <mixed-citation>Donnenfeld, E.D., Perry H.D., Gibralter, R.P., at al.: Keratoconus associated with floppy eyelid syndrome. Ophthalmology, 1991; 98(11): 1674–8.</mixed-citation>
      </ref>
      <ref id="R12252">
        <mixed-citation>Dufek, M.A., Schechtman, D.L.: Floppy eyelid syndrome: a diagnostic dilema. J Am Optom assoc, 1999; 70: 450–454.</mixed-citation>
      </ref>
      <ref id="R12253">
        <mixed-citation>Ezra D.G., Beaconsfield, M., Sira, C. et al.: Long-term outcomes of surgical approaches to the treatment of floppy eyelid syndrome. Ophthalmology, 2010; 117(4): 839–46.</mixed-citation>
      </ref>
      <ref id="R12254">
        <mixed-citation>Gerner, E.W., Hughes, S.M.: Floppy eyelid with hyperglycinemia. 1984; 98: 614-616.</mixed-citation>
      </ref>
      <ref id="R12255">
        <mixed-citation>Grote, L., Sommermayer, D.: Early atherosclerosis and cardiovascular events. Eur Respir Mon, 2010; 50: 174–188.</mixed-citation>
      </ref>
      <ref id="R12256">
        <mixed-citation>Haentjens, P., Van Meerhaeghe, A., Moscariello, A., et al. The impact of continuous positive airway pressure on blood pressure in patients with obstructive sleep apnea syndrome: evidence from a meta-analysis of placebo controlled randomized trials, Arch Intern Med, 2007; 167: 757–764.</mixed-citation>
      </ref>
      <ref id="R12257">
        <mixed-citation>Karger R.A., White,W.A., Park,W.C. et al.: Prevalence of floppy eyelid syndrome in obstructive sleep apneahypopnea syndrome, Ophthalmology, 2006; 113(9): 1669–74.</mixed-citation>
      </ref>
      <ref id="R12258">
        <mixed-citation>Klozar, J.: Jak odstranit chrápání?, Interní Med, 2011; 13(1), 51–53.</mixed-citation>
      </ref>
      <ref id="R12259">
        <mixed-citation>Lagford, J.D., Linberg, J.V.: A new physical finding in floppy eyelid syndrome. Ophtalmology, 1998; 105: 165-169.</mixed-citation>
      </ref>
      <ref id="R12260">
        <mixed-citation>Lam, J.C.M., Lui, M.M.S., Op, M.S.M.: Diabetes and metabolic aspects of OSA, Eur Respir Mon, 2010; 50: 189–215.</mixed-citation>
      </ref>
      <ref id="R12261">
        <mixed-citation>Liu, D.T., Pasculate, M.A., Sawai, J., et al.: Tear film dynamics in floppy eyelid syndrome. Invest Ophthalmol Vis Sci, 2005; 46: 1188–94.</mixed-citation>
      </ref>
      <ref id="R12262">
        <mixed-citation>Lopez, P.P., Stefan, B., Schulman, C.I.: Prevalence of sleep apnea in morbidity obese patients who presented for weight loss surgery evaluation: more evidence for rutine screening for obstructive sleep apnea before weight loss surgery. Am Surg, 2008; 74: 384–388.</mixed-citation>
      </ref>
      <ref id="R12263">
        <mixed-citation>Madjlessi, F., Kluppel, M., Sundmacher, R.: Die Operation des Floppy Eyelids. Klin Monatsbl Augenheilk, 2000; 216: 148–151.</mixed-citation>
      </ref>
      <ref id="R12264">
        <mixed-citation>Martinez-Garcia, M.A., Soler-Cataluna, J.J., Ejarque-Martinez, L., et al.: Continuous positive airway pressure treatment reduces mortality in patients with ischemic stroke and obstructive sleep apnea: a 5-year follow up study. Am J Respir Crit Care Med, 2009; 180: 36–41.</mixed-citation>
      </ref>
      <ref id="R12265">
        <mixed-citation>Mazal, Z.: The floppy eyelid syndrom. Čs Oftalmol, 1990; 46(6): 134–438.</mixed-citation>
      </ref>
      <ref id="R12266">
        <mixed-citation>Miyamoto, C., Santo, L., C., E., Roisman, L. et al.: Floppy eyelid syndrome: review. Arq. Bras. Oftalmol., 2011; 74 (1): 64–66.</mixed-citation>
      </ref>
      <ref id="R12267">
        <mixed-citation>McNab, A.A.: Floppy eyelid syndrome and obstructive sleep apnoe. Ophtal plast reconstr Surg, 1997; 13: 98–114.</mixed-citation>
      </ref>
      <ref id="R12268">
        <mixed-citation>McNab, A.A.: Reversal of floppy eyelid syndrome with treatment of obstructive sleep apnoea. Clin experiment Ophthalmol, 2000; 28: 125–6.</mixed-citation>
      </ref>
      <ref id="R12269">
        <mixed-citation>McNaab, A.A.: The eye and sleep, Clin Experiment Ophthalmol, 2005; 33(2): 117-25.</mixed-citation>
      </ref>
      <ref id="R12270">
        <mixed-citation>McNicholas, W.T., Bonsignore, M.R..: Sleep apnoea as an independent risk factor for cardiovascular disease: current evidence, basic mechanisms, and research priorities. Eur Respir J, 2007; 29: 156–178.</mixed-citation>
      </ref>
      <ref id="R12271">
        <mixed-citation>Nevšímalová, S., Šonka, K., et al.: Poruchy spánku a bdění, Praha, Galén, 2007; 345 s.</mixed-citation>
      </ref>
      <ref id="R12272">
        <mixed-citation>Parra, O., Arboix, A., Montserrat, J.M., et al.: Sleep related breasing disorders: impact on mortality of cerebrovascular disease, Eur Respir J, 2004; 24: 267–272.</mixed-citation>
      </ref>
      <ref id="R12273">
        <mixed-citation>Periman, L.M., Sires, B.S.: Floppy eyelid syndrome: a modified surgical technique. Ophthal Plast Reconstr Surg, 2002; 18: 370–372.</mixed-citation>
      </ref>
      <ref id="R12274">
        <mixed-citation>Riha, R.L.: Genetic aspects of obstructive sleep apnoea-hypopnoea syndrome. Somnologie, 2006; 10: 101–112.</mixed-citation>
      </ref>
      <ref id="R12275">
        <mixed-citation>Schlotzer-Schrehardt, U., Stojkovic, M., Hofmann-Rummelt, C., et al.: The pathogenesis of floppy eyelid syndrome: involvement and elastic fiber degradation. Ophthalmology, 2005; 112: 694–704.</mixed-citation>
      </ref>
      <ref id="R12276">
        <mixed-citation>Sergi, M., Salerno, D.E., Rizzi, M. et al.: Prevalence of normal tension glaucoma in obstructive sleep apnea syndrome patients. J Glaucoma, 2007; 16(1): 42–6.</mixed-citation>
      </ref>
      <ref id="R12277">
        <mixed-citation>Šonka, K., a kol.: Apnoe a další poruchy dýchání ve spánku. Praha, Grada, 2004; 247 s.</mixed-citation>
      </ref>
      <ref id="R12278">
        <mixed-citation>Tasali, E., Ip, MS.: Obstructive sleep apnea and metabolic syndrome: alterations inglucose metabolism and inflammation. Proc Am Thorac Soc, 2008; 15: 207–217</mixed-citation>
      </ref>
      <ref id="R12279">
        <mixed-citation>Tkáčová, R.: Spánkové apnoe a ochorenia kardiovaskulárného systému. Praha, Galén, 2006; 194.</mixed-citation>
      </ref>
      <ref id="R12280">
        <mixed-citation>Veale, D., Rabec, C., Labaan, J.P.: Re piratory complications in obesity. Breath, 2008; 4: 211–223.</mixed-citation>
      </ref>
      <ref id="R12281">
        <mixed-citation>Yaggi, H.K., Concato, J., Kernan,W.N., et al.: Obstructive sleep apnea as a risk factor for stroke and dech. N Engl J Med, 2005; 353: 2034–2041.</mixed-citation>
      </ref>
      <ref id="R12282">
        <mixed-citation>Ye, L., Pien, G.W.,Weaver,T.E..: Gender differences in the clinical manifestation of obstructive sleep apnea. Sleep Med, 2009; 10: 1075–1084.</mixed-citation>
      </ref>
    </ref-list>
  </back>
</article>
