Management
20
Floppy Eyelid Syndrome
Î Temporary relief of floppy eyelid syndrome is afforded by taping the
patient's eyelids shut or by having the patient wear a protective shield
while sleeping. (III, I, D)
Î Lubricants may help in managing mild cases. (III, I, D)
Î Definitive therapy involves surgical procedures such as full-thickness
horizontal shortening of the upper eyelid to prevent the upper eyelid
from everting. (III, I, D)
Î Follow-up depends on the patient's clinical course. (III, I, D)
Î Referral for evaluation of the mitral valve prolapse and sleep apnea
should be considered. (III, I, D)
Giant Fornix Syndrome
Î Concomitant nasolacrimal duct obstruction and chronic dacryocystitis
may need to be addressed surgically. (III, I, D)
Î Treatment with antibiotic regimens used for routine cases of bacterial
conjunctivitis generally results in only temporary improvement.
(III, I, D)
Î Recommended treatment strategies include prolonged use of systemic
anti-staphylococcal antibiotics. (III, I, D)
Î Recommended treatment strategies include intensive topical
antibiotics and corticosteroids. (III, I, D)
Î Supratarsal injections of antibiotics and corticosteroids, along with
irrigation and sweeping of the fornix with povidone-iodine solution,
have been advocated. (III, I, D)
Î Conjunctival cultures before starting treatment can help guide the
appropriate choice of antibiotic. (III, I, D)
Î Surgical correction of the ptosis may play a role. (III, I, D)
Pediculosis Palpebrarum (Phthirus pubis)
Î Jeweler's forceps can be used to remove the adult lice and nits
mechanically from the eyelids and eyelashes. (III, I, D)
Î Adherent nits may require epilation of the involved lashes. (III, I, D)
Î A bland ophthalmic ointment applied 2–3 times a day for 10 days will
smother the adult lice and nits. (III, I, D)
