Body mass index is associated with orbital pulley degeneration syndrome, including sagging eye syndrome.

Sagging eye syndrome (SES), esotropia with high myopia including heavy eye syndrome, and age-related esotropia (ARE)-collectively termed orbital pulley degeneration syndrome (OPDS)-are characterized by strabismus with orbital pulley lateral rectus-superior rectus band impairment. Herein, we examined body mass index (BMI) in OPDS to determine SES-associated anthropometric characteristics. Retrospective cohort study. We compiled and analyzed the BMI of patients aged ≥50 years who underwent strabismus surgery at a single center in Shizuoka, Japan, between July 2020 and March 2023. BMI (kg/m There were 78/126 and 49/119 patients in the OPDS/non-OPDS and SES/non-SES groups (age: 70.4±9.5/66.0±9.6 years, p=0.002 and 75.0±6.0/66.6±9.5 years, p<0.001; BMI: 21.2±3.3/23.2±3.0 kg/m Patients with OPDS, including SES, had lower BMI than other patients with strabismus. Therefore, BMI may be a clinical clue to SES.

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