One eye bigger and getting tired easily (Photo)

Question

I am 27, female. My eyesight is perfect, I've had LASIK done when I was 21. However, ever since I was a kid I felt like my left eye was "smarter" - like I see 3D with it, while "only 2D" with my right eye. Often my right eyelid appears droopy, but not always. I find it hard to fall asleep sometimes because my left eye feels worn out and it causes me one-sided headaches (esp. if I lack exercise). Also I don't like how it looks in photos sometimes. Had MRI done, all good there. What could it be?

Kenneth D. Steinsapir, MD · Answer

It is probable that there is some type of compensation for the ptosis that may affect the left upper eyelid and that needs to be investigated at the time of your personal consultation.  There are two approaches to ptosis and testing at the time of consultation determines which of the approaches would be best for you.  Due to the history of Lasik, you are at risk of dry eye and that also needs to be considered in planning an eyelid surgery for you.

Ross A. Clevens, MD, FACS · Answer

Thank you for your question. I suggest that you consult with a board certified facial plastic surgeon as a blepharoplasty can address excess skin and fatty tissue around the eyelids. Best wishes,

Kathleen Waldorf, MD, FACS · Answer

You appear to have slight eyelid ptosis. I would direct you to be seen by an oculoplastic surgeon for evaluation and recommendations for repair.

Parviz Goshtasby, MD, FACS · Answer

Hello 'lumixxx', thanks for your question.  It is difficult to ascertain the source of your issue without a full history and physical exam.  If you truly are developing a droopy eyelid during the day, it may be worth checking for a condition called myasthenia gravis, which is an autoimmune disorder leading to neuromuscular weakness.  A neurologist or ophthalmologist can help work this up.  Your photo overall looks OK, other than perhaps a minimal ptosis of the right eyelid compared to your left, which sounds like it is congenital if you had it since you were a child.  There is ptosis eyelid surgery that can be performed to address this, but there are risks with any surgery and you need to weigh the pros and cons of trying to fix a minimal issue with the risks of potential complications.  I would suggest a neurology eval first, and if you are still interested in cosmetic eyelid options, be sure you seek a board-certified plastic surgeon for a thorough consultation. Good luck!-Dr.92660

John R. Burroughs, MD · Answer

First off, you have beautifully shaped eyes, but I agree your right eye is slightly ptotic (droopy) compared to your left.  Most of us have one side of our face and orbits (eye sockets) that is smaller than the other.  However, this does not mean our eyelids are not usually of symmetric heights (space between the lower eyelid margin to the upper eyelid margin).  It is tough to tell from your one photo, but your right pupil may be slightly smaller than your left.  There is a condition called Horner's syndrome whereupon the droopy eyelid also has a smaller pupil.  It can have some serious systemic associations.  I'm not sure why you are getting strain with your left eye.  This could be secondary to a refractive error (need glasses) or it could be getting drier since it is more open than the other eye.  I'm glad your MRI was normal.  If you haven't seen an ophthalmologist then I would suggest you do so to be sure nothing serious going on.  If you wanted to have micro ptosis surgery to lift your right eye more open I would suggest Guy Massry (Beverly Hills), Ken Steinsapir (Beverly Hills), or Robert Goldberg (UCLA, Jules Stein).  Each of these surgeons are national leaders and carry excellent reputations.  Best regards.

One eye bigger and getting tired easily (Photo)

Answers (5)