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Frequently in our practice a patient presents with chronic redness, irritation and a discharge from one eye. “You snore at night and sleep on your right side.” patient answers,”How on earth do you know that?!”

What is Floppy Eye Lid Syndrome?

Floppy eyelid syndrome (FES) is considered a common and under-diagnosed eyelid syndrome. FES is characterized by a loose or “floppy” eyelid that easily contorts or everts without spontaneously returning to its normal shape. Typical presenting symptoms include tearing, irritation, photosensitivity, and foreign body sensation in the eye.

Who develops Floppy Eye Lid Synrome

Studies suggest that 98% of patients with FES are male and 57% of patients with FES suffer from Obstructive Sleep Apnea.

What is Sleep Apnea

This is when you stop breathing while asleep or have almost no airflow. It combines the Greek roots “a,” which means “not” and “pnea,” which refers to breathing. Combined, it means “breathless.” Sleep apnea is a potentially serious sleep disorder. If you snore loudly and feel tired even after a full night’s sleep, you might have sleep apnea.

The main types of sleep apnea are:

• Obstructive sleep apnea (OSA), which is the more common form that occurs when throat muscles relax and block the flow of air into the lungs
• Central sleep apnea (CSA), which occurs when the brain doesn’t send proper signals to the muscles that control breathing
• Treatment-emergent central sleep apnea, also known as complex sleep apnea, which happens when someone has OSA — diagnosed with a sleep study — that converts to CSA when receiving therapy for OSA

How is Floppy Eye Lid Syndrome treated?

Regarding the eyes, patients can use metal shields to cover their eye(s) while sleeping to reduce the mechanical trauma. Medications can be tried to lessen the eye irritation, and there are surgeries which can be performed to tighten the eyelid and/or raise it to correct the drooping. However, unless the underlying obstructive sleep apnea is addressed, the condition will continue.

How does one get checked for Sleep Apnea?

You get booked for a sleep study, in a sleep lab or by a monitor at home. These studies determine if and how often your breathing pauses for a significant period of time while sleeping. Remarkably, people with obstructive sleep apnea may have hundreds of episodes each night in which they stop breathing for 15 seconds or longer.

Why is it important to diagnose and treat OSA?

Obstructive sleep apnea reduces oxygen flow to all parts of the body. This can lead to high blood pressure, heart failure, arrhythmias, and many other potentially fatal systemic diseases. In addition, the poor quality of sleep has effects on daytime performance at work and other activities. Management of the condition always starts with diet, exercise, and weight loss. Once diagnosed, it can be treated with continuous positive airway (CPAP) masks and/or mouth and nose pieces to prevent collapse of the airway while sleeping. Treated patients sleep more soundly, feel better, and are healthier. Often, once the sleep apnea is treated, the changes seen on the eyelids will slowly revert to normal without the need for surgery.

Patient seen before and after treatment of obstructive sleep apnea with CPAP device. Note the improvement in position and appearance of the right upper eyelid.

For further information Fourie and Associates can be contacted. Fourie & Associates Clinical Technology Group is a team of experienced technologists with advanced sleep facilities in Cape Town, Johannesburg and Pretoria. They help patients understand, diagnose and treat sleep disorders such as sleep apnea using latest technology and expert advice to combat fatigue and daytime sleepiness.

The Vera Wang Eyewear Collection is characterized by a modern take on light, form and structure. Using innovative techniques, all handmade with the highest quality of craftsmanship.

In a recent interview with Vision2020 magazine, Vera Wang discusses life as a designer and reveals her newest role – starring in her eponymous Eyewear campaign for the first time.

Vera Wang has always had a passion for eyewear. “I’m a collector; I probably have over 1,000 pairs of frames. Maybe more,” says the fashion designer. If that surprises you—it shouldn’t. Wang studies eyewear and notices every minute detail, fine-tuning her designs until they exceed her very high standards. She has partnered with Kenmark Eyewear since her initial eyewear collection launched in 2001, and she still somehow manages to keep us on our toes. Twenty years later, the designer adds model to her long resume after starring in her eyewear campaign for the first time.

Wang began her career in the industry at Vogue, becoming one of the magazine’s youngest fashion editors. As an accessories editor for almost 17 years, she worked with and studied eyewear on a daily basis. “It really was not what it became—what it evolved to be. Over the last 50 years eyewear has changed so much,” says Wang. 

It is clear that Wang is not just in eyewear for the license. She knows it. She knows all of the players and has designed with some of the best in the industry. She brings her vision and style to life, but still prioritizes technicality and comfort.

What makes eyewear so important to you?

Flicker Glass is designed to overcome many shortcomings of traditional “occlusion” treatments such as patching and atropine therapy. Standard occlusion, though rudimentary, can be effective in improving visual acuity – but only with high compliance starting from a young age. The discomfort, disruption, and social and psychological stigma associated with patching can make compliance difficult and cause undue burden and stress for the parent and child. Compliance with patching can also take a long commitment – two to six hours each day, often for half a year or longer.

Improvements with current therapies may be temporary, and monocular occlusion can introduce or exacerbate other visual challenges, such as problems with eye teaming, depth perception and effective hand-eye coordination – impacting quality of life. Visual acuity has historically been the standard measure of improvement with patching, but it is just one element of vision performance. From a patient care perspective, exploring ways to treat underlying suppression and improve stereopsis may have more meaningful benefits.

Eye care professionals are increasingly focusing on binocular therapy approaches. Eyetronix Flicker Glass is a simple, wearable tool for binocular therapy that integrates known principles of the visual system and flicker, combined with the clinical experience of practicing eye care professionals. 

Flicker Glass uses rapid alternating occlusion, at flicker frequencies shown in research to help break suppression. Instead of occluding to penalize one eye and forcing the signal from the other eye, the theory is that using flicker can gently stimulate the visual system and encourage both eyes to naturally work together, ultimately aiding in the restoration of binocular vision and depth perception.

Flicker Glass offers a novel, more natural, intuitive approach to binocular vision conditions.

Flicker Glass was created to help avoid the struggle and burden otherwise associated with current traditional therapies. It may be worn for just 1-2 hours a day, while enjoying regular home activities like reading, doing puzzles, watching TV, or playing video games. Flicker Glass does not require specific, repetitive exercises. With Flicker Glass, binocular therapy is less obtrusive and can fit with any lifestyle and schedule.

In contrast to current available treatments, Eyetronix Flicker Technology is based on research of sensory function in the visual pathway between the eyes and the brain. In normal binocular vision, both eyes focus on an … to create one stereoscopic (3D) image. When a disorder in binocular vision is present, however, a neurological problem causes the brain to favor one eye and suppress vision in the other.

Therefore, the key to breaking suppression is to “wake up” that sensory pathway and encourage the brain to accept visual sensory signals from both eyes. The Eyetronix Flicker Technology approach is to gently stimulate the visual system to break suppression and restore the normal binocular fusion process to perceive one 3D image.

In a recent clinical study conducted with Flicker Glass, results showed significant improvement in both visual acuity and stereopsis – even into older age ranges typically considered more challenging to treat. Study investigators were impressed with the remarkable levels of compliance, and patients and parents rated Flicker Glass highly on ease of use, comfort, and preference over traditional monocular therapies. From a quality of life perspective, reports of improved reading and sports performance supported the overall positive evaluation of this novel Flicker Glass experience.