The results of clinical examinations and follow-up of 7 patients with floppy eyelid syndrome are presented. The most prominent features of the syndrome are floppy upper eyelids that can be easily everted, with papillary conjunctivitis and punctate keratopathy. The ocular changes seem to be the result of an underlying metabolic (or endocrine) disorder. In the patient with the longest follow-up period (10 years) considerable loss of body weight resulted in a dramatic relief of ocular symptoms.