It affects middle-aged, obese men who sleep face down with their eyelids everted on the pillow and is a hypermobility of the eyelids that makes them easily everted by pulling vertically upwards or by gently pressing the skin under the eyebrow. There may be chronic micropapillary conjunctivitis of the superior tarsal conjunctiva, punctate keratopathy, and filamentous keratitis. It is also found in blepharoptosis, eyelash ptosis, and ectropion.

Treatment: in mild cases, it consists of lubrication with artificial tears during the day and lubricating ointment at night with occlusion to avoid eyelid eversion, together with modification of the sleeping posture. When conservative treatment fails, surgical correction can improve symptoms by horizontal shortening and tightening of the upper eyelid.