Saint with the old eyelid problem (4)
I believe the answer is:
stye
'eyelid problem' is the definition.
(I've seen this before)
'saint with the old' is the wordplay.
'saint' becomes 'st' (abbreviation).
'with' is a charade indicator (letters next to each other).
'the old' becomes 'ye' (resembles a historical spelling of 'the').
'st'+'ye'='STYE'
(Other definitions for stye that I've seen before include "Ocular affliction" , "producing eyesore" , "It pains viewer" , "Tamworth residence" , "makes viewer sore" .)