Eyelid Ptosis or Extra Skin?

Looking at your picture, I see several interesting things. First both lower lids are a bit droopy, but right more so than left. Note increased scleral (the white of the eye), especially laterally. Consideration to a lower lid tightening and repositioning procedure should be entertained. Next, the upper lids seem about equal, but the left side has a deeper fold, and it may be due to your brows (there is asymmetry present). I would also agree with the other doctors. So what to ask? Ask for... more

 I agree, your left eye does appear to be ptotic.  It is best to see an occuloplastic surgeon to have this evaluated and treated. Ptosis surgery can be tricky so make sure your surgeon does this operation frequently. 

The higher position of your left upper eyelid crease is very suggestive of ptosis. One of the most common findings in ptosis is elevation of the lid crease. In many cases, ptosis is bilateral. If the left eye alone is corrected, there is potential for the ptosis in the right eye to be unmasked. I would recommend an ASOPRS trained occuloplastic surgeon.

From looking at your picture, it seems to me that you may have asymmetry of your upper eyelids due to unilateral ptosis of the right eyebrow. I do see drooping of the right upper eyelid compared to the left. However, if you should lift the right eyebrow, and look again, both upper eyelids may look more symmetrical. That is something that you should ask your doctor.

You have a very slight assymetry between the eyes. Asymmetry is the rule rather than the exception in most cases: Your right brow is silghtly lower, the left lid is borderline ptotic, ie it covers just a hair more of the upper part if the iris than the right lid and has a higher crease.  It is up to you  and the surgeon to decide to what degree you would like these corrected.

There is asymmetry on both upper lids. The eyelid crease on the left eye is higher than the right, and this is what you were born with. Asymmetrical upper eyelid surgery can be performed more so on the right eyelid than the left to make them more symmetrical.

Your picture is not head on but taken from your upper left side down. From this angle you demonstrate a normal eye asymmetry but, in my opinion, you do have mild ptosis of your left upper lid. I cannot tell from this picture if the upper eyelid creases are at the same level. A higher crease on the left than the right would further suggest a mechanical (rather than neuromuscular) cause for the ptosis. As regards your consultation, I would keep your initial comments brief and let the surgeon... more

 Eye asymmetry is very common. This can be the result of different orbital bony shapes, volumes, eyeball size, etc.. This is normal. The eyelid creases can be different as a result.  Without a formal exam it is difficult to offer specific advice.  

It is difficult to tell for sure from one picture. However, I do not think that you have ptosis. One way to tell is to measure the distance from the light reflex on your eye to the edge of the upper eyelid. It appears to me that the distance is the same on both sides. You do have some facial asymmetry (like most people). The left upper lid is more hollow than the right. That makes the crease look higher and the lid look lower. Judging from the picture it may be difficult to make... more

The position of the eyelid margin of the left upper lid is lower as compared to the right upper lid. This is termed ptosis (or blepharoptosis). There are different varieties of ptosis with different causes. Luckily, these are often corrected with the appropriate procedure. With a history of ptosis on the other lid, you should see an oculofacial plastic surgeon who can evaluate your ptosis, rule out rare and serious causes of ptosis, and help you to find a solution.

From the history and photographs that you provided it appears that you have a ptosis of the left upper lid. This can best be observed with the the high eyelid crease on the left and the fact that the lid margin is lower on the left eye versus the right. You also have extra skin, dermatochalasis of the right upper lid but in my experience, a ptosis repair of the left upper lid should be just what you need.

 Your left eye looks ptotic and your history of it being worse with fatigue is supportive of this diagnosis.  Go to an ophthalmologist who does a lot of ptosis repairs for an exam and possible correction.