Queensland Eye Institute (QEI) scientists are developing a promising new approach to treating eyelids which have become abnormally loose or floppy, a condition known as eyelid laxity. In more severe cases, weakened eyelids can result in sight-threatening conditions, including chronic irritation and inflammation of the eye surface.

The QEI research aims to develop a minimally invasive treatment which reinforces the eyelid’s natural supporting structure and reduces excessive looseness, potentially providing an alternative to conventional eyelid-tightening surgery.

Through a technique called ultraviolet A (UVA) collagen crosslinking, the affected eyelid would undergo chemical changes to make the tissue stronger, firmer and more resistant to stretching.

Why do eyelids become loose?

The eyelids contain a firm supporting structure called the tarsal plate, which is made largely of connective tissue. Two important proteins within this tissue are collagen, which provides strength, and elastin, which allows tissues to stretch and return to their original shape.

Eyelid looseness can develop when naturally occurring substances called enzymes break down these proteins. As collagen and elastin fibres deteriorate, the organised network that normally supports the eyelids becomes disrupted. This can weaken the tarsal plate and contribute to the excessive looseness seen in certain eyelid conditions.

Potential new treatment for eyelid laxity

The QEI research team is working on a non-invasive treatment to reinforce the eyelid’s natural supporting structure without the need to surgically remove or tighten tissue.

Collagen crosslinking involves creating additional connections between collagen fibres, making the tissue stronger, firmer and more resistant to stretching.

To achieve this, the researchers apply a light-sensitive substance called riboflavin, also known as vitamin B2, to the tissue before exposing it to UVA light. When riboflavin absorbs UVA light, it helps trigger chemical reactions that create new connections between collagen fibres.

The UVA light is delivered through the conjunctiva, the thin membrane lining the inner surface of the eyelid. This allows the light to reach the underlying tarsal plate, where the collagen-strengthening process is intended to occur.

Collaboration

This research commenced in 2018 in close collaboration with colleagues at the George E. Palade University of Medicine, Science, Pharmacy and Technology in Romania. After seeing promising results with animal collagen, the research teams began studying this method’s effects on human tissue. Their findings, published here, show that using ultraviolet-A light on eyelid tissue is a safe and effective way to reduce eyelid laxity in human patients.

Patents for the novel treatment have been granted in Australia and the United States.

Key research findings in 2026

While the technique has shown promise in research to date, further work has been done in 2026 to investigate the effects of light exposure on the delicate eyelid tissues.

Testing whether UVA crosslinking can strengthen damaged eyelid tissue

The QEI research team used eyelid tissue in laboratory experiments, exposing samples to enzymes that break down collagen or elastin before applying UVA crosslinking.

The study provided encouraging early evidence that UVA-induced collagen crosslinking may help restore the mechanical strength of weakened eyelid tissue, even after some of its supporting collagen and elastin fibres have been damaged. The measured improvements support further investigation of the proposed treatment.

Chief Scientist Professor Traian Chirila says this is significant because many conditions involving loose or floppy eyelids are associated with the gradual breakdown of these structural proteins.

“This proposed new treatment aims to strengthen the eyelid’s existing supporting tissues rather than relying solely on surgical tightening,” Professor Chirila says.

“A treatment that strengthens the remaining connective tissue could potentially help restore eyelid firmness and improve its ability to maintain its normal shape.”

Impact of proposed treatment on surrounding structures

In this study, QEI scientists examined eyelid tissue after treatment with riboflavin and UVA light, measuring the impact of the treatment on surrounding eye tissue.

Microscopic examination revealed no significant visible damage to the main structural components of the eyelid. In particular, the study found no evidence of injury to the cells within the supporting tissues, the connective tissue itself, the meibomian glands or the eyelid muscles.

Although the examination was limited to two tissue-staining techniques and could not exclude all possible biological effects, QEI’s Chief Scientist Professor Traian Chirila says the findings were encouraging.

“Examining these structures was important because any treatment designed to strengthen the eyelid must avoid damaging the tissues responsible for its normal function,” Professor Chirila says.

“More studies are needed to assess its effects on living tissues, investigate any longer-term impacts and establish whether this treatment can safely and effectively strengthen weakened eyelids in patients.”

Determining appropriate UVA light intensity and exposure times

The QEI research team also investigated whether delivering the same total amount of UVA energy at different intensities and durations would produce equivalent effects on eyelid tissue.

A relatively gentle light exposure lasting several minutes might be expected to have the same effect as a more intense exposure lasting a shorter time, provided the total energy delivered is identical.

However, results from QEI experiments showed the eye tissue response was not always the same, identifying conditions under which the expected relationship between intensity and exposure time became unreliable. Delivering the same total amount of light energy did not necessarily produce the same biological response when the intensity and duration of exposure were changed.

These findings are important because they demonstrate that simply increasing the light intensity to shorten treatment time may not produce the same results as a longer exposure at lower intensity. The tissue’s response can change in ways that are not predicted by the total amount of light energy alone.

Measuring tissue heating during UVA treatment

Researchers also investigated another aspect of safety: temperature changes on the inner surface of the eyelid during UVA exposure.

The eyelid surface is covered by a thin, delicate membrane called the conjunctiva, which lines and helps protect and lubricate the eye. Immediately beneath it lies the tarsal plate, the structure the treatment aims to strengthen.

Excessive temperature rises could damage collagen and other tissue components, potentially undermining the benefits of the procedure.

To test the impact of the experimental treatment, researchers used infrared cameras to measure temperature changes on the inner surface of eyelids during UVA exposure. This technique, known as infrared thermography, allows temperature changes to be monitored without touching or disturbing the tissue.

By comparing the results across different exposure settings, the researchers were able to determine how both the intensity of the light and the duration of treatment affected tissue temperature, observing that heating was not expected to reach temperatures associated with collagen damage. The findings provided encouraging preliminary evidence about thermal safety.

Overall findings and significance

These latest research findings provide a clearer understanding of the structural changes associated with loose eyelids.

The studies offer encouraging early evidence that UVA collagen crosslinking may offer a new way to strengthen weakened eyelids, while identifying the further testing needed before clinical application.

This world-leading research is made possible by generous donations to the Queensland Eye Institute Foundation. Donate at this link.

Sources

Pop N.E., Suzuki S., Tripon R.G., Manta A.I., Lee K.M., Parisot M., Cocisiu A.G., Radford M.H.B., Harkin D.G. and Chirila T.V.: Photochemical crosslinking of eyelid tissue by trans-conjunctival exposure to UV-A radiation: implications for biological safety. J. Biophotonics, 19(1): e202500458, 2026.

Suzuki S., Pop N.E., Manta A.I. and Chirila T.V.: Ex vivo thermographic analysis of the eyelid conjunctival surface during ultraviolet A-mediated photochemical crosslinking of tarsal collagen: A step in the translational safety evaluation. Global Transl. Med., 5(1): 87–94, 2026.

Chirila T.V., Suzuki S., Parisot M., Koba M., Manta A.I. and Harkin D.G.: Photocrosslinking of enzymatically degraded tarsal plate in ex vivo ovine eyelids: Biomechanical and histological analysis. Open J. Ophthalmol., 16(2): 182–195, 2026.

Chirila T.V., Suzuki S., Pop N.E., Cattelot C. and Manta A.I.: Photocrosslinking of tarsal collagen for treating eyelid laxity: Applying the exposure reciprocity law to establish an optimal irradiant profile. J. Biomed. Photonics Eng., 12(3): 030301, 2026.