Is there anything I could do for scleral show? (photos)

It is best to see an oculoplastic specialist in person for evaluation. There are definite treatment options available, and the best choice depends on your exact anatomy, including eyeball prominence, cheek bone prominence, and lower eyelid tension, among other factors.

Thank you for the photo.  Your iris cannot be made in a larger or any different in its appearance.  I have heard of lasering for changing of the pigment but I know nothing about those particular therapies and would discourage people from doing them until they are better understood and have been utilized longer.Regarding her scleral show, in young patients like you it is best left alone from a surgical standpoint.  Lateral canthoplasty or canthopexy is performed in reconstructive situations for ectropion or epiphora (chronic tearing of the eye).  I rarely would recommend it for cosmetic purposes and rather than making the eye look more elongated and larger it can sometimes make it look smaller.  This is particularly true when trying to adjust scleral show.  In some cases where patient has a week midface or the facial bones in the front of the face below the eyes doesn't have much projection and consequently the lower eyelids are pulled down a bit.  I had some nice results when augmenting the midface and lateral orbital rim and tear trough with fat transfer in young patients but it is a mild improvement and does not everyone is a good candidate.  I'll attach a a website link.  In that particular photo the patient did have a very weak midface and we augmented that with fat transfer along with her upper eyelid surgery.  It created a very slight lift of the lower eyelids that frankly you can barely see.  The most benefit she received from the fat transfer was nice contouring and rounding of the midface.Chase Lay, MDDouble board-certified facial plastic surgeon

You have nice wide eyes which leads to some scleral show and any procedure to decrease the show is gong to narrow the eyelid opening.  I do not know of any procedure to increase the size of your iris.  What about colored contacts with the colored area larger than your current iris?  Otherwise I would encourage you to leave them alone.

Occasionally, a condition called anisocoria will cause unequal pupil size (or as you are describing: different sized irises).  Physiologic anisocoria is considered a normal variant.  Other more sinister causes may contribute to this presentation.  If this is physiologic anisocoria then there are different types of eye drops may be used to either constrict or dilate your pupils in an attempt to produce symmetry - though this is rarely necessary and given you have dark brown eyes the asymmetry is relatively hidden.Changing the scleral show is achievable with surgery.  Though your picture does not necessarily provide accurate information about your lower eyelids.  You appear to be looking up to the camera and therefore you will invariably have an excess of scleral show.  Pictures to evaluate the marginal reflex distance (MRD) need to be taken in the "frankfort horizontal" to properly define the relation of the eyelids to the pupil and iris.  As mentioned above other relationships of the eyelids to your midface and the laxity of your eyelids are important in determining the correct intervention.

Dear Myloh, I would encourage you to leave well enough alone. You have beautiful eyes and slight scleral show that is natural and not from a lower lid blepharoplasty should be left alone. There is no surgery to make your iris larger and any surgery to correct the scleral show would change the shape of your eyes and not advised. Best regards, Michael V. Elam, M.D.