Lazy Eye Syndrome May Be Linked to Sleep Apnea

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Patients with eyelid ptosis, also called lazy eye or floppy eyelid syndrome, should be aware of the possible link between the condition and an increased risk of having obstructive sleep apnea, a sleep disorder where a person awakens several times a night due to breathing interruptions, says a small study published in the April issue of the journal Ophthalmology.

Dr. Daniel G. Ezra of Moorsfields Eye Hospital in London and colleagues conducted a case-control study of 102 patients with eyelid ptosis and 102 matched controls from a diabetic retinopathy clinic. The researchers found that about a third of the patients with a floppy eyelid had obstructive sleep apnea, representing a 12.5-fold increased risk. The association held even after controlling for what was thought to be a primary risk factor – obesity.

Ptosis literally means a drooping or sagging of a body part. Drooping of the upper eyelid is called blepharoptosis and occurs when the muscles that raise the eyelid are not strong enough to do so. There Congenital ptosis is a genetic condition from birth and can further be broken down into more specific classes that describe the eyelid or muscle that is affected or other contributing factors, such as nerve damage. Acquired ptosis is a secondary condition from trauma, injury, or disease that affects a nerve or muscle that attaches to the eyelid.

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During sleep, patients with blepharoptosis can experience a distortion of the upper eyelid, causing the eyelid to flip up during sleep and leading to dry, irritated eyes or discharge.

The word apnea means “without breath”, and those with obstructive sleep apnea experience a stopping of breathing repeatedly during sleep, sometimes hundreds of times during the night and often for a minute or longer. It is caused by a blockage of the airway, usually when the soft tissue in the rear of the throat collapses.

Both sleep apnea and blepharoptosis are more common in obese adults and diabetics. The researchers of the study also believe that both conditions may have a common factor that causes a decrease in connective tissue remodeling.

Source reference:
Ezra DG, et al "The associations of floppy eyelid syndrome: A case-control study" Ophthalmology 2010; DOI: 10.1016/j.ophtha.2009.09.029.

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