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Why Are my Eyes Different Sizes?

I'm in my late 30s but I only started noticing a few years ago that my eyes are shaped differently and uneven.

Looking back at old photos I guess it has always been there, but it seems to be getting worse. People around me tell me it's unnoticeable but I think they are just being nice. What is the cause and is there a fix?

Doctor Answers 16

Eyelid asymmetry

Looking at your photo, there appear to be a couple of differences between the two sides.  First of all, the left brow is elevated compared to the right.  Often this is simply a physiologic/normal difference, but it can suggest the presence of an underlying issue such as a droopy or ptotic left upper lid.  In this case you use the brow to elevate the lid to a more normal position.  There is a slight retraction of the left upper lid that may be related to the brow, or might be associated with other issues such as thyroid abnormalities.  It is also possible that the left eye is more prominent, either congenitally or due to an orbital process.  Certainly there are other possibilities as well.

I suggest you see an oculofacial plastic surgeon to further identify the underlying process and how best to treat it.  Try the ASOPRS website to find a physician.


Philadelphia Oculoplastic Surgeon
5.0 out of 5 stars 14 reviews

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Uneven Eyebrows and Eyelids

Many causes of unevenness exist regarding the eyebrows and eyelids, and accordingly, many people have differences in the position of their eyebrows and eyelids.  The most common causes are differences in underlying bone (in which the orbital bone projects more on one side), brow position (in which one eyebrow is positioned lower than the other), and eyelid anatomy (in which excess skin can exist or the muscles that control the eyelids are different from one side to the other).

Based on the photo provided, it is difficult to assess the evenness in the underlying bone.  The right eyebrow is certainly lower than the left and the right eyelid appears to have excess skin relative to the other side.  Reviewing old photos is helpful and suggests that this is most likely a congenital difference rather than an acquired problem.  A thorough physical exam of your periorbital anatomy would be helpful.  

If the main things that bothers you is the eyebrow position, then two primary options exist. The minimally invasive one would include Botox (or other related neurotoxin).  The degree of elevation using this technique is limited, but its a reasonable first step.  A more powerful (but more invasive) option is surgery to lift the eyebrow (which often addresses the excess eyelid skin as well).  A brow lift can be performed endoscopically, hiding the incision in the forehead hairline.  

The solution for you is likely straight forward.  Best of luck.

Jeffrey Cone, MD
Austin Plastic Surgeon

Different sized eyes

Most of us have asymmetry between our two eyes predominantly from different sizes and shapes of our underlying bony orbits.  On the left your opening in the orbit is larger in size as you can notice that your left brow is higher.  Your eye is also sitting more forward giving you more visible upper eyelid compared to the right.  Your right eye sits more deeply in a smaller orbital opening.  The asymmetry our eye picks up most is in the upper lid difference.  You could consider an upper bleph on the right to remove skin and then Restylane filler to the left upper lid fold to make the lower portion of the lid less visible.

Katrinka L. Heher, MD
Boston Oculoplastic Surgeon
5.0 out of 5 stars 4 reviews

Eyelids Uneven or Asymmetric

Asymmetry in the eyes and orbits are common. At your age, you may want to consider botox to help raise the right eyebrow. To understand your options, consult with 3 experienced and expert board certified plastic surgeons who are master injectors.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 22 reviews

Uneven eyelids and eyebrows

Thanks for this very appropriate question.  The answer may not be too complicated, because you are presenting a picture that can be fairly common in patients.  You do not appear to have a ptosis( droopiness) to the left lid, and do raise your left eyebrow in an effort to attempt to raise the eyelid.  You may be surprised how many patients do this.  I would not do anything at this age to correct this, unless you may want to raise the right eyebrow with a localized Botox injection.

Always consult your local Plastic Surgeon for further advice.

Good luck to you.

Frank Rieger M.D.  Tampa Plastic Surgeon

Asymmetric Eyes Are Extremely Common

Asymmetry of the eyes and orbit are extremely common and when looked at closely, most people have some asymmetry.  In your case, asymmetry is present although it’s relatively minor.

I would not recommend treatment for this type of mild deformity because of the risk benefit ratio.  When the potential for improvement relative to the complication rate is minimal, this is not a risk worth taking.

There are a variety of causes of orbital asymmetry.  It may be related to the boney orbit, the eyelid, or the brow itself.  In most cases of mild asymmetry, there is some asymmetry of the bones surrounding the eye.  This cannot be treated without major surgery.  If you continue to have concerns about your asymmetry, it would be appropriate to consult a board certified plastic surgeon.

eyelid asymmetry

 The eyelid asymmetry is due to the asymmetrical eyebrow position, where one eyebrow is lower than the other. When this occurs the eyelids will have to be asymmetric.
 To repair this asymmetry, consideration for either a browlift to make the eyebrows symmetrical,or a one-sided upper blepharoplasty. If you perform the upper blepharoplasty,  the eyebrows will still be asymmetric. An in person examination/consultation is required to make any decisions.

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 62 reviews

Asymetry of the two sides of the face are common and can cause uneven eyes

Most everyone has a slight asymmetry of the face most often caused by unequal bony development between the two sides.

The orbit or bony socket that holds the eyeball may be the cause of your asymmetry and if this is the cause it would be difficult to correct. Other causes such as ptosis or drooping eye can cause asymmetry as well. Your left eyebrow is more elevated, a very common asymmetry.

See an Ophthalmologist for a formal eye exam and consultation. Most likely this is a normal variation but it is best to get an expert opinion

Asymmetry of the Eyelids and Brows

Dear Michael,

There are some differences this photo shows between your eybrows and and eyelids.  You seem to be arching your left eyebrow which can often suggest mild left lid ptosis (droopy lid). Other findings such as bony asymmetry, differences in the position of the eyeball (termed enophthalmos) can often result in eyelid and eyebrow asymmetry.  If you would like to get a consultation, I would recommend looking up an oculoplastic surgeon in your area (ASOPRS.org) and visit them for an evaluation. 

Hope this helps and good luck.

Christopher I. Zoumalan, MD, FACS
Beverly Hills Oculoplastic Surgeon
5.0 out of 5 stars 87 reviews

Eye asymmetry

Hi,

It is normal to be a little asymmetric, most people are.  I would make an appointment and see someone with experience in eyelid surgery.  It may be a little early as you do not have much excess skin.  You may also have a degree of eyelid ptosis (drooping) that you may be holding up by arching your left eyebrow, but it would be impossible to tell without a physical examination.

Best,

Nima Shemirani

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 44 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.