Floppy eyelid syndrome (FES), a clinically recognized condition of lax and rubbery eyelids, is commonly under-diagnosed. It is associated with chronic papillary conjunctivitis and is often, although not always associated with obesity and obstructive sleep apnea. Symptoms of FES mimic those of ocular surface disease; indeed FES itself can contribute to ocular surface damage. Diagnostic signs of FES can include foreign body sensation, ocular discharge, injection, and eyelid and eyelash ptosis. Palliative topical measures may be inadequate for symptomatic relief necessitating surgical eyelid repair.