Conjunctiva and cornea: floppy eyelid syndrome: practice question

A Ophthalmology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Ophthalmology · Conjunctiva and cornea: floppy eyelid syndrome

Sample item

An obese man with loud snoring wakes with red, irritated eyes. His upper lids evert very easily with a rubbery, lax tarsus and the upper tarsal conjunctiva shows a papillary reaction. Which systemic condition should be looked for?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Obstructive sleep apnoea

Floppy eyelid syndrome affects obese middle-aged men who sleep with the lid pressed against the pillow, and is strongly linked to obstructive sleep apnoea and to keratoconus. Treating the apnoea and protecting the lid at night improves the eye signs.

Option by option

  • A. Myasthenia gravis

    Myasthenia causes fatigable ptosis and diplopia and not a papillary lid eversion syndrome.

  • B. Sjogren syndrome

    Sjogren syndrome causes keratoconjunctivitis sicca, not a lax rubbery tarsus.

  • C. Hypothyroidism

    Hypothyroidism is not characteristically associated with a lax, easily everted tarsus.

  • D. Obstructive sleep apnoea (correct)

    Correct. The syndrome is strongly associated with obstructive sleep apnoea.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Ophthalmology question

What is the answer to this Ophthalmology question?

The best answer is D, Obstructive sleep apnoea. Floppy eyelid syndrome affects obese middle-aged men who sleep with the lid pressed against the pillow, and is strongly linked to obstructive sleep apnoea and to keratoconus.

Why is "Myasthenia gravis" not the answer?

Myasthenia causes fatigable ptosis and diplopia and not a papillary lid eversion syndrome.

Why is "Sjogren syndrome" not the answer?

Sjogren syndrome causes keratoconjunctivitis sicca, not a lax rubbery tarsus.

Why is "Hypothyroidism" not the answer?

Hypothyroidism is not characteristically associated with a lax, easily everted tarsus.

What concept does this question test?

It tests Conjunctiva and cornea: floppy eyelid syndrome in Ophthalmology. Treating the apnoea and protecting the lid at night improves the eye signs.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Conjunctiva and cornea: floppy eyelid syndrome?

Group the red eye by what to examine and what the pupil does. Then use the flashcards and the other Ophthalmology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.