Abstract

A FLOPPY EYELID SYNDROME IN PACHYDERMOPERIOSTOSIS CASE

REPORT: SURGERY, CLINICAL AND

HISTOPATHOLOGIC FEATURES

Karina Adistiarini, Irene Titin Darajati, Banu Ajii Dibyasakti, Purjanto Tepo Utomo, Agus
Supartoto

Reconstructive, Oncology, and Oculoplastic Subdivision, Departement of Opthalmology,

Faculty of Medicine, Public Health and Nursing, Gadjah Mada University

Background

Floppy eyelid syndrome (FES) was defined as eyelid hyperlaxity with reactive
palpebral conjunctivitis. This is a common condition that can cause significant eye irritation.
This syndrome is often underdiagnosed because of non-specific complaints, such as eye
irritation, redness, mucoid debris, and light sensitivity.

FES presents with a clinical picture of an easily inverted eyelid and chronic papillary
conjunctivitis of the upper eyelid. This is common with eye and system diseases one of which
is discussed in this case report is a connective tissue disorder such as Pachydermoperiosis.
This comprehensive review describes the epidemiology, pathological changes, clinical
manifestations, and various treatment options for this condition. Preventive treatment of FES
and in refractory cases, corrective surgery that corrects eyelid weakness so as to produce
optimal results.

CASE REPORT
a 27-year-old man came with complaints of difficulty in opening his eyelids, the
eyelids seem looser, with swelling of the joints of the hands and feet, the patient's facial and
body skin looks piled up and bulking accompanied by hyperexcretion of the oil glands, the
patient is a routine outpatient control patient from the division dermato-venereology and
plastic surgery related to his complaint, from the skin division the patient was diagnosed with
pachydermoperiostosis syndrome. For ophthalmological status, visual acuity was OD 6/6 OS
6/6, ptosis eyelids were accompanied by a floppy eye lid.
the external examination showed a significant eversion of the left upper eyelid with
minimal upward traction.Ocular management was initially conservative with lubricating
ointment and included taping the eyelid shut at night.
Due to severity of his symptoms, the patient was elected for surgical repair. A
lateral pentagonal upper eyelid resection was performed in the left eye [Figures 2 and 3], and
eyelid tissue from the patient was examined using light microscopy and
immunohistochemistry.
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Seven days after the surgery, the patient presented immediate relief of his symptoms