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 21

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 21 reviews

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 7 reviews

Eyelid asymmetry

 Hello and thank you for your question. A common question I always get from patients is why their eyelids appear asymmetric. There are several reasons for this, but most importantly no two eyelids or eyebrows are completely symmetrical. They're always variations in the anatomy.  From your pictures, and most commonly, asymmetries occur because the eyebrows do not sit in the same place. In addition some patients have ptosis of the eyelid.  This is when the upper border of the eyelid sits low because the muscle is loose. When you have these asymmetries, please make sure you discuss it with your surgeon who can give you an idea of how realistic it is to create symmetry. Please consult with the plastic surgeon. Hope this helps and good luck!

Kailash Narasimhan, MD
Sherman Plastic Surgeon
5.0 out of 5 stars 12 reviews

You have right upper eyelid ptosis

the difference between the two eyes is due to ptosis of right upper eyelid. This can be repaired with simple procedures like Mulleractomy or Levator advancement in the office. 

Differences

Everyone has varying degrees of differences from one side of their body to the other - no two ears, eyes, breasts were created equally.  With surgery, we try to create symmetry as best we can but again - no one is perfectly even from side to side. 

Joshua A. Greenwald, MD
New York Plastic Surgeon
4.9 out of 5 stars 107 reviews

Eye shape asymmetry

All people will have differences between their two eyes.  As a matter of fact, one eye will be more round or almond in shape while the other will be slightly more narrow.  In your case, I see nothing but normal anatomy.

John Burns, MD
Dallas Plastic Surgeon
4.6 out of 5 stars 30 reviews

Why Are my Eyes Different Sizes

Thank you for your question. Our faces are all asymmetrical. There are differences in the bone, and fat distribution on one side of the face in comparison to the other.  Options include fat transfer, brow lift, eyelid surgery, botox, fillers, etc. I personally would not recommend anything invasive for you at this time for you. Botox to help lift the right eyebrow would help.  Best wishes

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 Physician
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
4.4 out of 5 stars 33 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

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.