Is this much eye asymmetry normal? What are my options? (Photo)

Eyes can be asymmetric for many different reasons:  different set of the globe within the bony orbit, orbital volume differences, orbital dystopia, ptosis, brow asymmetries, lid hooding etc etc etc.  Each one of those reasons has a different solution!In your case, you may be well served with a little Botox periodically.  A physical exam is of course necessary but it is not immediately obvious that you have a condition requiring complex surgery.  I would prefer to try a few conservative things first.

You might have left upper eyelid ptosis which causes the same side eyebrow to raise but proper eye evaluation by an oculoplastic specialist is necessary to determine the exact cause of the eye asymmetry.

You have bilateral anterior levator disinsertion ptosis.  In the photo, you have left upper eyelid retraction with a compensatory eyebrow elevation.  A detailed personal assessment is needed to determine the best surgical approach for this.  Generally the levator disinsertion is repaired and an anchor blepharoplasty is performed. A prior history of eyelid surgery will have an impact on the complexity of this work.

Asymmetry is natural and due to many factors (bone, skin, fat, muscle, eye position, medical conditions etc) It is best to have an in-office evaluation to see what is causing this asymmetry. Some issues can be easily corrected or camouflaged well others may require serious surgery that may not be worth the risk. Hope this helps! Johnson C. Lee, MD 
Board-Certified Plastic Surgeon
@drjohnsonlee

It appears to me from the photo that your provided that it isn’t really your eyes that are different, rather your left brow is higher than your right brow so it pulls up on your left eyelid creating a wider appearance. I don’t know if you have Botox or other neurotoxins in your forehead, but sometimes this can be the cause. Our frontalis muscles are sometimes stronger on one side rather than the other, requiring more or less botox to balance it out. Surgically, you could have a browlift on one side, but as young as you are, I would not recommend it. What I might suggest is Ultherapy isolated to your right brow to tighten the skin and soft tissue of your right brow to try to match your left. This happens gradually over time and will give the most natural appearance of a 2-3 mm lift.  You may want to consider a filler to the right brow to lift that side temporarily while you wait for Ultherapy results to kick in. Good luck!

You don't just have eye asymmetry, you have a whole 1/2 face asymmetry; but before you get worried, remember that everybody has asymmetric facial halves; in the embryonic phase to sides of the face develop independently and thus if you start staring at your friends/family/etc. you will realize that almost everyone is asymmetric if you draw a line down the middle of their face ! Denzel Washington is famous for being an exception with very symmetric halves.