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 25

Eyelid asymmetry

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
 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!


Saint Petersburg Plastic Surgeon
5.0 out of 5 stars 18 reviews

Different sized eyes

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
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 8 reviews

Eyelid asymmetry

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

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.

Alan B. Brackup, MD, FACS
Philadelphia Oculoplastic Surgeon
4.9 out of 5 stars 38 reviews

Why Are my Eyes Different Sizes?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

First, diagnosis based off of a single photo is insufficient and inaccurate compared to an in-person physician consultation including review of past medical history and examination of your facial bone structure with dynamic facial movements.

Second, your question is a very frequent concern among patients from every background and location in the world regarding paired body parts. Doctor, "Why is my left part X bigger than my right part X?," or visa versa. In the vast majority of cases, the answer is that this is normal asymmetry. In terms of facial structure, most every individual on the planet, including models, actors/actresses, and others considered "very attractive," have some degree of facial asymmetry. 

Third, based on your photo alone, your left eyebrow peak is the most pronounced asymmetry (>4mm higher peak than right) followed by the amount of upper eyelid skin showing on your left versus right (several mm more show on left versus right with a higher lid fold placement). A physical exam would be prudent to evaluate for left upper lid ptosis (lid elevator muscle weakness). There are several conservative approaches to attain the illusion of symmetry before considering surgery, however, including simply shaping the left eyebrow more similar to the right. If you don't like it, the hair will grow back!

The next steps to consider before surgery, after determining you have no left upper lid ptosis, would be a trial of neuromodulator therapy (botox, dysport, etc) in an asymmetric fashion to lower the left and raise the right brow. 

If non-surgical intervention proves insufficient, there are many surgical approaches to attain the desired result as mentioned by several other colleagues on this post. 

Thank you for your question.

Uneven eyelids

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Many different situations can lead to uneven eyelids. Some of these can be treated non-surgically and conservatively, even using some very advanced injection techniques with filler or very precise placement of Botox. Some situations truly do require surgery to resolve. 

It is important that you seek a consultation with an eyelid expert to delineate the exact cause and treatment options.

To ensure you are receiving the highest level of care, seek out a modernly trained, new-school dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these "core four" cosmetic specialties. Membership in organizations like the American Academy of Facial Plastic and Reconstructive Surgery help to identify a highly trained surgeon.

Cameron Chesnut

#realself500 Physician

Cameron Chesnut, MD, FAAD, FACMS
Spokane Dermatologic Surgeon
4.9 out of 5 stars 123 reviews

Uneven Size of Eyes

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Having asymmetrical eyes are actually more common than you may think. Based on the photo that you have included and looking closely at it, it is noticeable that your left eyebrow is fixed higher compared to your right brow. I believe that this is the major difference. However, you need not worry, as facial asymmetry is common. You can observe these when looking carefully at different faces. If this still bothers you, you can undergo a unilateral brow lift to help even things out.

That said, aside from natural asymmetry, it could also be possible that an underlying asymmetrical issue in your bone is the cause of your eyes’ uneven sizes. It may be a hypoplastic maxillary sinus. This means that the cavity in your face’s middle section is tinier on one side compared to the other. This will be better determined if you visit a doctor for a more thorough assessment and check-up.

Robert W. Sheffield, MD
Santa Barbara Plastic Surgeon
4.9 out of 5 stars 23 reviews

Eye asymmetry

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

This is much more common than one would think. If you look closely your left brow is higher than your right. I think that is the main difference. Again this is common if you look closely at many faces. A unilateral brow lift can help with this.  It is possible you have a bony asymmetry that is underlying. Sometimes it can be a hypoplastic maxillary sinus. That just means the cavity in the middle of your face is smaller on one side than the other. It has no importance unless you are to under go a sinus surgery it should be noted. 

Hope this helps.

Best of luck,

DrC

Benjamin Caughlin, MD
Chicago Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

You have right upper eyelid ptosis

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
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

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
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. 

Eye shape asymmetry

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
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 L. Burns Jr., MD
Dallas Plastic Surgeon
4.7 out of 5 stars 59 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.