title: Eyelid, conjunctival, and corneal findings in sleep apnea syndrome.
abstract: OBJECTIVE
  To determine the prevalence of eyelid, conjunctival, and corneal findings in patients with sleep apnea syndrome (SAS).
  
  
  METHODS
  Case series.
  
  
  METHODS
  Seventy-two white patients referred for evaluation of suspected SAS.
  
  
  METHODS
  Complete examination of eyelids, conjunctiva, and cornea, including videokeratography.
  
  
  METHODS
  Spearman rank correlations were determined between the respiratory disturbance index (RDI) during night sleep, a value used to diagnose and grade SAS, and tear film break-up time, eyelid distraction distance, presence or absence of ocular irritation symptoms, blepharoptosis, floppy eyelids, lacrimal gland prolapse, keratoconus, and endothelial dystrophy. Each correlation was controlled for age and body mass index.
  
  
  RESULTS
  According to the RDI, 44 (61 %) of the 72 patients had SAS. The RDI correlated positively with the eyelid distraction distance (P = 0.05), presence or absence of floppy eyelids (P = 0.01), and lacrimal gland prolapse (P = 0.01), and correlated negatively with tear film break-up time (P = 0.02). None of our patients with floppy eyelids had corneal abnormalities. One patient with SAS had bilateral keratoconus; another had bilateral Fuch endothelial dystrophy.
  
  
  CONCLUSIONS
  Sleep apnea syndrome was significantly associated with reduced tear film break-up time, floppy eyelids, and lacrimal gland prolapse. However, ocular irritation symptoms and corneal involvement were rare among patients with SAS. These findings do not confirm previous studies that reported a high prevalence of corneal involvement in floppy eyelid syndrome.
authors.affiliation: Department of Ophthalmology, University of Bern, Switzerland. daniel.mojon@insel.ch
authors.forename: D S
authors.initials: DS
authors.lastname: Mojon
authors.forename: D
authors.initials: D
authors.lastname: Goldblum
authors.forename: J
authors.initials: J
authors.lastname: Fleischhauer
authors.forename: A G
authors.initials: AG
authors.lastname: Chiou
authors.forename: B E
authors.initials: BE
authors.lastname: Frueh
authors.forename: C W
authors.initials: CW
authors.lastname: Hess
authors.forename: M
authors.initials: M
authors.lastname: Gugger
authors.forename: C
authors.initials: C
authors.lastname: Bassetti
authors.forename: M
authors.initials: M
authors.lastname: Boehnke
authors.forename: J
authors.initials: J
authors.lastname: Mathis
mesh_terms: D000328:Adult; D000368:Aged; D003229:Conjunctival Diseases / Q000150:complications*; D003316:Corneal Diseases / Q000150:complications*; D019781:Corneal Topography; D005141:Eyelid Diseases / Q000150:complications*; D005260:Female; D006801:Humans; D007766:Lacrimal Apparatus Diseases / Q000150:complications / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D011391:Prolapse; D011446:Prospective Studies; D012891:Sleep Apnea Syndromes / Q000150:complications*; D013666:Tears / Q000378:metabolism