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121 EW MEETING REPORTER tively, Dr. Melicher said. Associated ocular conditions can include floppy eyelid syndrome, papilledema, glau- coma, central serous chorioretinop- athy, and worsening diabetic and hypertensive retinopathy. The pathophysiology of floppy eyelid syndrome includes significant decrease in tarsal elastin, resulting in eyelid laxity due to upregulation of elastolytic protease, Dr. Melicher said. Eyelid laxity allows eversion, inadvertent rubbing of the eye or lateral stretching of the lid through contact during sleep. With floppy eyelid syndrome, there is overall diffuse stromal loss, the stroma is relatively maintained around the meibomian glands, and loss of stromal architecture around the ciliary processes results in lash ptosis. For treatment, Dr. Melicher said her go-to procedure is a pentagonal wedge resection. It's critical to treat the horizontal portion of the eyelid before vertical tightening. In summary, Dr. Melicher said that OSA is associated with multiple ocular conditions, but treatment of OSA will improve associated ocular disease. EW Editors' note: Dr. Melicher has no financial interests related to her presentation. losporine 0.05% q.i.d., autologous serum tears q.i.d., and scleral lenses. Just 3 months later, the patient had improved markedly, and Dr. Fram was able to have the discussion of getting into a scleral lens. It's im- portant to lift the lid and make sure you're getting topographies on dry eye patients, Dr. Fram said. Editors' note: Dr. Yeu has financial interests with a number of ophthalmic companies, including Allergan, TearLab (San Diego), and Shire. Dr. Fram has no financial interests related to her presentation. Oculoplastics Jill Melicher, MD, Minneapolis, discussed techniques for handling floppy eyelid syndrome in the era of obstructive sleep apnea (OSA). OSA is the most common type of sleep-disordered breathing. One in four men and one in 10 women have OSA, with most patients undi- agnosed. Ophthalmologists can play a critical role in the recognition of symptoms and diagnosis of associat- ed findings, Dr. Melicher said. Risk factors for OSA include obe- sity, large neck size, enlarged tonsils in children, a small airway due to nasal congestion or bony structure, family history of apnea, increasing age, and male gender. It's important to screen these patients preopera- View videos from COS 2017: EWrePlay.org Elizabeth Yeu, MD, discusses outcomes for astigmatism correction with cataract surgery. September 2017