The vascular anatomy of the eyelids has been studied in more detail with regard to possible applications in eyelid surgery. The recognition of different subtypes of eyelid laxity, eg, floppy eyelid, lax eyelid, and eyelid imbrication syndromes, as underlying causes of conjunctival and corneal irritation will contribute to their successful management. Involvement of eyelid, conjunctiva, or cornea has been reported in association with systemic diseases such as Wegener's granulomatosis, xeroderma pigmentosum, scleromyxedema, sarcoidosis, and abnormalities of mitochondrial DNA. The ocular manifestations may be the presenting feature of the underlying disease. Results in two series of patients with ocular surface diseases such as chemical and thermal eye burns suggest that the use of autologous nasal mucosa transplantation is promising for the management of this disorder. Clinical features and results of cryotherapy are reviewed in two series of patients with congenital distichiasis and trichiasis due to ocular cicatricial pemphigoid.