Dr. Allen Putterman wrote a commentary in the August issue of The Aesthetic Surgery Journal.  It was on the surgical correction of upper eyelid ectropion presenting with dry eye symptoms.  He presented how to treat upper eyelid ectropion secondary to floppy eyelid syndrome which occurs in obese patients with sleep apnea.  The upper eyelid flips over in sleep and causes irritation and further elongation and laxity of the lid.  Removing a full thickness section of the upper eyelid shortens and tightens the lid, and corrects the ectropion and eye irritation.