Floppy eyelid with hyperglycinemia.

A 31-year-old man with spastic paraparesis (diagnosed when he was 10 years old) and hyperglycinemia (diagnosed when he was 19 years old) had an intermittently swollen right eye and blurred vision. His right upper eyelid was S-shaped and edematous, the lateral canthal tendon was flaccid, and the eyelid everted easily. After the floppy eyelid syndrome was diagnosed, the patient underwent a tarsal strip procedure to shorten and tighten the lax upper eyelid. This relieved his symptoms, which have not recurred in the year since surgery.