Can I Fix Asymmetrical Eyes?

Question

Hi, My eyes are different sizes (and shaped differently), and it really bothers me. Please see attached photo. Is this possible to fix? If so, is it a complicated surgery? Thank you!

Kenneth D. Steinsapir, MD · Answer

Dear Eyequestion

	As I look at your photos, I see several issues.

	First, and this is easy enough to determine by looking at your eye glass prescription, it appears that your right eye is mildly near slighted and your left eye is mildly far sighted.  This arrangement will make you right eye look slightly smaller relative to your left eye because lens that correct for near slightedness have the optical effect of making the eye look smaller and lens that that correct for correct for far sightedness have the optical effect of making the eye look bigger.  The net effect influences how you perceive the relative size of the two eyes.

	The next thing that I notice is that the right eye sits higher in your face than the left eye.  Occasionally this is due to a slight chronic head tilt but more often it is related to facial skeletal asymmetry.  These types of problems are generally left unaddressed unless severe.

	FInally, your right upper eyelid is heavy or ptotic by 1 mm compared to the left side.  There is also an accompanying compensatory right eyebrow elevation.  

	I think that an assessment by an oculoplastic surgeon would be appropriate.  A detailed consultation can help determine which of these issues is bothering you and how best to address them.  The American Society for Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) maintains an excellent geographic directory of ASOPRS members that will help you find someone in your area who is a fellow of this society.

Steve Laverson, MD, FACS · Answer

Your palpebral aperture (vertical distance between upper and lower eyelid margins) does appear asymmetric, but the exact nature of this asymmetry can only be determined by close examination and measurement. The procedure(s) to correct depend on the cause(s) of your asymmetry. See a Board Certified Plastic Surgeon, or several in your area, to learn more. Accurate restoration of symmetry is a delicate and complex procedure.

Scott Trimas, MD · Answer

The short answer to your question is yes the symmetry can be improved. It may be due to more skin on one side or the position of the lower eyelids. It is hard to tell from the photos. However, you have a reasonable problem that can be addressed.

Mehryar (Ray) Taban, MD, FACS · Answer

The asymmetry is likely due to the eyelids, which can be improved.  It could also be due to your eye position (if one is more prominent than the other) or due to bony asymmetry of the face and orbits.  There are nonsurgical and surgical options to address all of these.  I recommend a consultation with an oculoplastic surgeon.

	Dr Taban

Patrick Boulos, MD · Answer

A complete exam with an oculoplastic surgeon, as well as a possible CT-scan to follow will help determine which eye is problematic. If the problem is in your left orbit, a thyroid orbitopathy that causes eye muscles to increase in size or orbit fat to increase in volume is the most likely diagnosis. Other possible orbital problems include a mass pushing the eye forward making it look bigger. If the problem is in your right orbit, your surgeon will look for something that causes the eye to sink back such as an old undiagnosed orbital fracture. If the eye is the problem, it is because of a different eye size on one side. A near-sighted eye (myopic) would be larger making it look bigger, which is possibly the case on your left side. If eyelids are the problem, eyelid retractions make an eye look bigger (as on your left side) wile a droopy upper eyelid (ptosis) makes an eye look smaller (as on your right side). Of course, a full exam with glasses off would help differentiate these various causes. Most of these possibilities are treatable medically or with orbital or eyelid surgery and yes, it is possible to make your eyes look more symmetrical. Good luck!

William Portuese, MD · Answer

There is no fix for asymmetrical eyeballs. There are some modifications that can be done to the blepharoplasty procedure to correct asymmetrical eyelids by doing asymmetrical surgery. Occasionally one eyelid is puffier than the other and excess fatty deposits are removed more on the puffy eyelid than the opposite eyelid. Occasionally the upper lids are asymmetrical and this can be brought more into symmetry by performing techniques such as differential fat removal, sometimes a strip of orbicularis muscle can be taken on the full side and more skin can be taken on the fuller side than the more hollow side.

Sam Goldberger, MD · Answer

Yes, asymmetrical eyes can be fixed. The main question I have regarding your picture is what do you look like behind those glasses. Differences in glasses prescription can magnify your eyes in varying amounts either worsening or improving asymmetry. It is best to get a consultation with an Oculoplastic surgeon to identify all the factors causing your asymmetry and then come up with a proper treatment plan.

Darryl J. Blinski, MD · Answer

Yes it is possible to improve or lessen the asymmetry. But in person evaluation is best. From MIAMI Dr. Darryl J. Blinski

Robert T. Buchanan, MD (retired) · Answer

Many procedures are available to correct eye asymmetry. The only way to know what is possible is to consult a surgeon with significant experience in eye surgery.

Can I Fix Asymmetrical Eyes?

Answers (9)

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