Sleep apnea, floppy eye syndrome, and glaucoma

How do your eyes feel? This report is about one of my favorite topics: floppy eyelid syndrome. You’ve never heard of it? It is, indeed, a real thing. But although the name of this syndrome is a little silly, the syndrome itself is not. Floppy eyelid syndrome (FES) is present when the eyelids above the eye are simply floppy. Most people with FES indicate that their eyelids previously had not been as floppy in the past, so it is something that develops over time. Interestingly, there have been previous studies that have linked sleep apnea with FES, such that untreated apnea can increase the risk for FES. Similarly, there have also been studies linking sleep apnea with glaucoma. But although these studies are both “of the eye,” does it mean they are related? Does having one of them, in addition to sleep apnea, increase your risk for the other?

This answer was sought by a group of researchers in Madrid, Spain, who examined 75 participants with obstructive sleep apnea (OSA) + FES, a group of 50 participants who had OSA but no FES, and 25 participants with none of the above. All participants underwent testing for glaucoma, which included “computerized perimetry and retinal fiber layer measurements with optical coherence tomography” – basically a lot of fancy testing.

Results showed that in those without FES or OSA, 0% of the participants had glaucoma. In those who had OSA but no FES, the rate of glaucoma was 5.3%. Amazingly, in those who had both OSA + FES, the rate of glaucoma was a whopping 23%!

These results indicate that in those with sleep apnea and floppy eye syndrome, the chances of having glaucoma are relatively high. This does not mean that sleep apnea necessarily caused both FES and glaucoma in every case – it may mean that there is another underlying factor that has triggered both of these disorders. Importantly, though, if you have sleep apnea and you feel that you might have FES, glaucoma, or both, it is imperative that you consult a physician. As we have previously discussed that sleep apnea increases the risk for falls in old age, it is crucial that eyesight is at or near 100%!

Muniesa, M., Sánchez-de-la-Torre, M., Huerva, V., Lumbierres, M., & Barbé, F. (2014). Floppy eyelid syndrome as an indicator of the presence of glaucoma in patients with obstructive sleep apnea. Journal of glaucoma, 23(1), e81-e85.

Janna Mantua


Janna is a PhD Student / Graduate Research Assistant at University of Massachusetts Amherst with a background in clinical sleep research and psychology. Janna Mantua is a PhD student in the Behavioral Neuroscience department at the University of Massachusetts. Her research focuses on sleep and aging, with specific projects on cognitive health, inflammation, memory formation, and neuroimaging. Prior to her PhD work, Janna was involved in research on sleep apnea and cognitive decline at the NYU Sleep Disorders Center.

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