Is my left eye smaller than the other? Is it a droopy eyelid? Looking for solutions, tired of being asked if I am tired (Photo)

Question

I have perfect vision last time I was tested, but I've always seemed to have a droopy left eyelid. I'm 32 years old now, but I have a pictures in my teenage years with this issue prevalent. I've noticed when I drink alcohol, the eyelid droops more and people always ask if I'm tired. I'm looking for an assessment of my issue here and possible solutions, thank you!

Mehryar (Ray) Taban, MD, FACS · Answer

You have left upper eyelid ptosis or left eye sunken or both. See an oculoplastic specialist for evaluation. Treatment is possible.

Kenneth D. Steinsapir, MD · Answer

The condition is called upper eyelid ptosis.  Although the left upper eyelid is more droopy than the right upper eyelid, the right upper eyelid also looks heavy.  I suspect that you need both upper eyelids addressed.  The most common approach to ptosis is the Muller's muscle conjunctival resection ptosis surgery.  While it is immensely popular with ptosis surgeons, the anterior approach may be better for you.  This will be determined by a detailed personal consultation.  In a nutshell, those are your options.

Johnson C. Lee, MD · Answer

It appears that your left eyelid has mild ptosis (drooping). It is best to have an in-office examination to evaluate the degree of ptosis as well as the function of your underlying muscles and facial anatomy in BOTH eyes. Although only one eye appears to be droopy, adjusting one may affect the position of the other due to your brain's own compensatory reflexes. Multiple measurements are then put together to determine which surgical procedure is appropriate for your eyes for the safest and long-lasting results. Hope this helps!Johnson C. Lee, MD Plastic Surgery@Drjohnsonlee

Shoib Myint, DO, FAOCO · Answer

Hello andyo123,You have ptosis (droopy) of your left upper eyelid. If that is your main issue then a simple surgical procedure to lift that eyelid can be performed with excellent outcome. There are few risks as with any surgery and it should be discussed with your surgeon. Seek out an expert oculoplastic surgeon to go over in details the process. Good luck!Cheers

Andrew T. Cohen, MD, FACS · Answer

You have ptosis of the left eyelid.   I would recommend an Oculoplastic surgeon to repair this.  Go to someone that does a lot of ptosis repairs.     It is a difficult surgery with a high revision rate. Good luck.

Daniel Lensink, MD · Answer

Conditions where one eye is actually larger or smaller than the other are exceedingly rare, and would have involved eye doctors as an infant, so unless you have such a history, you absolutely do not have a difference in your eye size. It appears as though the left upper eyelid is slightly lower than the right, a condition we call belpharoptosis. Additionally, it looks like your left lower lid is slightly higher, as it covers the iris slightly more than the other eye. This is most likely just the way you were born, but could be because your left eye has settled back, or your right eye has slightly protruded, or you have an uncommon condition called Horner's Syndrome. Horner's syndrome is exceedingly rare and would also involve a smaller pupil on the left. I am unable evaluate your pupils from the photographs. At any rate, it is very ulikely anything significant is going on, but I would recommend you have a comprehensive eye examination by an ophthalmologist ( not an optometrist) or an oculoplastic surgeon.

David Rosenstein, MD · Answer

Hi,It seems like this is something that is bothering you. An upper bleph would definitely help open up your eyes and help make you look less tired as people are suggesting. Consultations are usually free, and an in-person exam is much more accurate than pictures alone. I would contact a plastic surgeon in your area. Best wishes!

Michael Elam, MD (retired) · Answer

Dear andyo123, You have some ptosis to both of the eyelids. I would see some expert surgeons for examination to determine your goals. Your brow position is low so you may consider an endoscopic browlift to lift the brows back to their pre-aging position. The incisions are small and hidden in the hair with no visible signs of surgery but allows a more youthful appearance. See examples in the link below and video as well. Best regards, Michael V. Elam, M.D.

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