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Why is One Eye Bigger and 'Higher' Than the Other? (photo)

I'm very concerned about my eyes. Over the last year or so, I've noticed that my eyes look very asymmetrical. One seems bigger and lower than the other. It never used to be like this. What are the potential causes of this? Not only is it upsetting me from a cosmetic angle, but I'm also concerned as this change coincides with substantial weight loss, palpitations & panic attacks (for the first time in my life!), high blood pressure and other stuff. Maybe I just have newly acquired wonky eyes! :(

Doctor Answers 9

Graves Disease and Eye Asymmetry

Review of your clinical history and pictures suggest that youmight have a condition known as Graves disease. This disease can cause a variety of changes that effect the eye. In some cases the eyeball is actually enlarged by a condition known as exophthalmos. This condition can also effect the eyelid, eye soft tissue, eye muscles, cornea and even the optic nerve.

                  In addition Graves disease can cause hyperthyroidism which can cause significant systemic problems. Examples include insomnia, hyperactivity, hand tremors, hair loss, excessive sweating, palpitations, muscle weakness, weight loss, panic attacks, cardiac arrhythmias and elevated blood pressure.

                  Your symptoms and physical findings suggest a diagnosis of Graves disease. It’s important that you undergo a comprehensive medical evaluation to address this problem. It’s important that your hyperthyroidism and eye changes both receive appropriate treatment. This may require an endocrinologist and an ophthalmologist who specializes in this type of problem. 

You need full medical evaluation

You should see your primary physician for full medical evaluation. Your eyes are normal . You have minimal asymmetry which is normal and does not need any intervention.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.5 out of 5 stars 93 reviews

Asymmetry of eyelids

You have a very minor degree of asymmetry if your eyes, which is not uncommon at all. I would consider the degree of asymmetry to be within the normal range.  However, it sounds like you have some other issuers which should be looked into further by your primary care physician.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 17 reviews

Asymmetry is the rule

No two eyes are symmetric.  With a split mirror, most people will note asymmetries. 

Regarding your situation, temporary changes can of course occur either spontaneously with changes in muscle activity, or with certain medications, injections such as Botox and of course surgery.

Your photograph shows your right eye and brow to be a bit more open/higher which looks like a Botox effect.  If you haven't had a Botox injection, don't panic.  You can consult with a plastic surgeon or opthalmologist who can reassure you and if appropriate, consider a simple treatment to improve the asymmetry.


David J. Levens, MD
Coral Springs Plastic Surgeon
5.0 out of 5 stars 38 reviews

Eyelid surgery for asymmetry

#eyelid surgery for asymmetry
Patients who would benefit from a blepharoplasty include those who experience:
#Asymmetry of the eyelids.
Excess skin or sagging of the upper eyelids (which can obscure vision)
Excess upper lid skin or hooding may be due to brow position

your eyes have minimal and normal differences but see your PMD or ophthalmologist

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 38 reviews

Eye Asymmetry and Medical Symptoms

I would talk to your primary care physician and get a full evaluation. Secondarily I would see an ophthalmologist or Oculoplastics and orbital specialist to measure your eyelid width to assure you are not dealing with a new onset eyelid retraction or proptosis which could necessitate treatment. 

Sounds like textbook description of Graves Disease

From your photograph and physical symptoms it looks and sounds like Graves Disease. It is common in this condition for an eyelid to retract upwards giving the startled appearance. After 1 year of stable appearance, the eyelid can be repaired by an oculoplastic surgeon. Artificial tears may be needed to prevent dryness. See your internist for some blood tests including thyroid function.  

Totally agree with Dr. McCracken.

First you appear to have upper eyelid retraction.  This is a sign of an overactive thyroid gland.  This of course fits in with your other hyper metabolic symptoms including palpitations, anxiety, weight loss, and heat intolerance.  Your primary care physician will be able to assess these symptoms and evaluate the thyroid with blood tests.  The treatment is to control the thyroid.  Your eye changes are mild and may less with time.  First start getting the  thyroid checked out.  

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
5.0 out of 5 stars 20 reviews

Uneven Eyes with Systemic Symptoms


I recommend that you see your primary care physician in the next day or two about your weight loss, palpitations, panic attacks, and blood pressure changes.  Ask him or her to do blood work to look for thyroid disease.  One possible explanation could be an abnormality in your thyroid hormone levels.  Thyroid disease can also cause changes in the appearance of the eyes.  Once you have seen your primary care doctor, you should see an oculoplastic surgeon (an ophthalmologist who does additional training in the eyelids and eye sockets) to evaluate your eyelid changes.  If you have vision changes you need to see an oculoplastic surgeon immediately.

Michael McCracken, MD
Lone Tree Oculoplastic Surgeon
5.0 out of 5 stars 11 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.