One eye is higher than the other. What can I do? (Photo)

Question

I have ptosis in my right eye due to BOTOX over the years. But my main concern is why my right eye is higher then my left. Also have droopy eyebrow it seems that might be affected from eyelid. I have been to see an ophthalmologist & have posted the consultation letter in photos above. Please could you advice me what I can do. The last time I had BOTOX was in February but I think I now have permanent damage

Mehryar (Ray) Taban, MD, FACS · Answer

Eye asymmetry can be a complex problem. Need personal evaluation to determine the cause of eye asymmetry. There are nonsurgical and surgical options for improvement.

Jonathan Britto, MB, MD, FRCS(Plast) · Answer

Hi Gem
You have given a very limited image which cannot substitute for a face to face consultation, as you know. Nonetheless the eyebrow and upper lid crease look symmetrical whilst the left lid 'shelf' (pre-tarsal show) seems longer than the right. This may be a left upper lid blepharoptosis, but because the left eye itself seems lower than the right (lower pupillary light reflex) I suspect the whole of the left eye is low. The lower lid is appropriate to the eye, therefore the left lower lid is also low. I think you have a vertical orbital dystopia - the whole of the left orbit is low. Its a natural asymmetry. A craniofacial or orbital - oculoplastic surgeon can give you your options. None are easy and all based upon appearance change where we always seek to minimise risk. 
Seek face to face advice always, and a few measurements will help you determine the details. There are no simple solutions and its worth noting that small personal differences in facial balance are an endearing reminder of individuality.
good luck

Jonathan Britto, plastic and craniofacial surgeon, London

Jane Olver, MBBS, FRCS · Answer

Facial and eye asymmetry is a reason many people have BOTOX, in order to try and even out the most apparent asymmetries. Often the underlying cause is a facial and orbital bony asymmetry or even an eye size asymmetry if one eye is more short sighted than the other. Indeed there are many causes and each patients cause can be different so you require an assessment by an oculoplastic surgeon.Thank you for your photo which shows one brow lower than the other. It may be possible to even out the eyebrow heights and hence the appearance of the eyes using BOTOX but it depends on the relative strengths of the various muscles acting around the eyes, which can only be assessed clinically.

Charles Nduka, MD · Answer

It would be very difficult to give an accurate assessment without n in person examination. Eye asymmetry is a very sensitive case and a photo of the eyes may seem to alter these due to different angles at which the photo was taken, the lighting, or the current eye position during the photo. Your best course of action would be to schedule an appointment with a board certified plastic surgeon for an in person examination and a detailed discussion of your surgical options.

Kami K. Parsa, MD · Answer

From your picture it looks like you may have orbital asymmetry. Which is very common. No one has 100% symmetrical eyelids.There are many causes of droopy eyelid which could be determined during an in person consultation where we would go over the best treatments available. For more information visit our website, we have helped thousands of patients with ptosis correction. Make sure you see an oculoplastic surgeon who specializes in the eyes.

One eye is higher than the other. What can I do? (Photo)

Answers (7)

Answer: One eye is higher than the other. What can I do?

Answer: One eye is higher than the other. What can I do?

Answer: Ptosis evaluation.

Answer: Ptosis evaluation.

Recommended reading

Everything you need to know about Ptosis Surgery

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One eye is higher than the other. What can I do? (Photo)

Answers (7)

Answer: One eye is higher than the other. What can I do?

Answer: One eye is higher than the other. What can I do?

Answer: Ptosis evaluation.

Answer: Ptosis evaluation.

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Recommended reading

Everything you need to know about Ptosis Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.