Lazy eye problem. What is the cause of it and the treatment? (Photo)

For like 5 years I had this problem and didn't do anything about it. My left eye is smaller than the other, especially when smiling. They are the same size only when I open my eyes maximally wide. What is the cause of it and the treatment? Some people advice glasses and say that it's because the one eye is not used "properly"... but actually I have better vision on the smaller eye.

Doctor Answers 2


It is hard to definitively diagnose a problem from a picture and I would recommend seeing an oculo-plastic surgeon which is an ophthalmologist with a concentration in plastic surgery specifically around the eyelids.

That being said, I can see what you are talking about from your pictures. It seems to me that your left eyelid is slightly droopier than the right and that you have some more skin on your right eyelid than your left. These two things are causing your eyelids to look asymmetric.

There are many possible causes for this and the only way to fix these problems is through surgery. I think you would benefit from a consult with an oculo-plastic surgeon to see what is the best option for you in order to make your eyes look more symmetric.

Ridgewood Oculoplastic Surgeon
5.0 out of 5 stars 44 reviews

Eye asymmetry

Is it that your lid does not open ? Or that the eyeball appears smaller? If it is the lid then you need to see someone who does ptosis surgery. If it is just that your eye appears smaller then a common issue is the sinus (maxillary sinus) that the eye sits on is smaller on the left side. This is called a hypoplastic maxillary sinus. Nothing to do. Not a safety issue or anything. It is important to note if you under go sinus surgery but other than that it is a normal anatomic variant.

As far as helping with the symmetry this is tough. Glasses do help camouflage but it does not sound like this is an acuity or vision issue so they would be only for looks. 

A CT scan would give you the final answer but is unlikely necessary as it won't change anything. 

Filers or fat transfer can help frame these eyes which can help somewhat but it is a difficult thing to make a big difference. 

If it is the lid that does not open then ptosis surgery helps. It is tough to get things exactly symmetric though to be honest.

Hope this helps.

Best of Luck


Benjamin Caughlin, MD
Chicago Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

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