My Eyes Are Completely Different Size, Shape, Vision? (photo)

My left eye is dramatically smaller than my right.(see picture) I was born with a tear in the pupil of my left eye which has limited its vision. In photos with flash my left eye will reflect the light almost like a cats eye. I haven't been to a doctor about it since I was very young. I was wondering if I could get any kind of advice on going about surgery to fix the size difference at the very least. I have lots of fear making eye contact with people because they might notice size difference.

Doctor Answers 7

Large pupil

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I agree that you definitely need an in-person evaluation to determine how to improve the symmetry of your eyelids. In terms of your pupil, a custom made contact lens can definitely help. The lens can be colored to match the shape of the pupil in the other eye and should also help reduce the amount of red eye in photos.

Eye vs Eyelid??

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Based on this photo, it is not entirely clear whether it is simply a droopy eyelid [ptosis] which is causing you to have a "smaller left eye", or whether it is possibly the position of the eyeball and the underlying bony eye socket which could be contributing to this asymmetry.

An in-person examination by an oculoplastics surgeon  is very important in your case. The position of the eyeball and the eyelid function can be assessed properly. A CT scan of the face/orbit may be required to rule out underlying bony asymmetry depending on the examination.

You can find an Oculoplastics specialist near you by going to the link I have provided below.

Also, since you have very dark irides, your pupil abnormality is not obvious. Though pupil surgery can be performed, it is likely not worth the risk for you.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 41 reviews

Eyelid droop

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Mahalo for your pictures.  There's not much that can be done about the pupil and cat's eye reflex in photos, but the lid margin can be adjusted quite effectively with or without an external incision.  Talk to your surgeon about these options.

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Lid Ptosis

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Thank you for your question.  You have some indicaitons of lid droop on your left. Ptosis repair surgery will help with eyelid asymmetry.  Consult a surgeon experienced with this procedure.  ALl the best.

Left eye smaller

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When examining your eyes closely and carefully, you have slight retraction of the right upper eyelid (the eyelid opens too much) and your left eye has slight Enophthalmos (the eye is slightly recessed in the socket) and it makes the crease of the left eyelid deeper and all this makes the left eye look smaller.  An Oculoplastic or Facial Plastic surgeon can evaluate this and may be able to surgically improve the situation.

Ptosis (droopy upper eyelid)

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You have left upper eyelid ptosis (droopy) due to either inherited or acquired weakness or relaxation of the levator muscle, which is the muscle responsible for lifting the upper eyelid. The droopy upper eyelid makes your eye look smaller. You would benefit from upper eyelid ptosis surgery.  See an oculoplastic surgeon.

Ptosis repair

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You should get a consultation from an oculoplastic surgeon for correction of ptosis.


These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.