Floppy Eyelid Syndrome

Floppy Eyelid Syndrome is an enigmatic condition characterised by loss of elasticity of the tarsal plate, papillary conjunctivitis and eversion of the eyelid at nighttime. Since the condition was first described approximately 40 years ago, there have been some significant advancement in the understanding of the pathophysiology of the disease which is a manifestation of changes in the structural components of the Extracellular Matrix and changes in the functional cell biology of the connective tissue fibroblasts within the tarsal plate. This chapter will also focus on the range of clinical features that FES can present with and appraise different approaches to conservative and surgical management of the condition. The latest advances in novel treatments such collagen cross linking of the tarsal plate to potentially increase rigidity of the eyelid will also be discussed.