My Right Eye is Lower Than my Left. How Can Symmetry Be Improved? (photo)

My right eye is lower than my left. I am unsure if they have always been asymmetrical. I do recall having a bicycle accident when I was younger which involved me landing on my face. How can the symmetry of my eyes be improved?

Doctor Answers 5

You have congenital right lower eyelid asymmetry- which is normal

Your picture shows that your right lower eyelid is lower than your left lower eyelid, leading to the asymmetry.  You can see more "white" below your right eye, and I agree with Dr. Amadi, that you have orbital asymmetry as well.  Facial asymmetry, orbital asymmetry, globe position asymmetry and eyelid asymmetry all go together.  You most likely have a more prominent (by a few millimeters) right eye due to a shallower orbit that leads to the right lower eyelid riding lower than the left.  

In fact, if you take a close look at my photos on my profile, you will see that my own right lower eyelid is in a similar configuration as yours. I have orbital asymmetry that is congenital that has led to my right eye being more prominent and the right lower eyelid riding lower.

It would be fairly simple to undergo a right lower eyelid retraction release by a few millimeters.  The incision would be hidden behind your eyelid, and the retaining tissue of the lower eyelid can be released slightly so that your right lower eyelid rides up to match your left side.  This would take about 10 minutes under local anesthesia.

Finally, I disagree with Dr. McDonald- a simple canthoplasty is not going to work, as that does not address the underlying problem.  I also disagree with Dr. Tobey who suggests forgetting about it-  if it bothers you enough to post about it, then the solution is fairly simple. 

Good luck to you!

Austin Oculoplastic Surgeon
5.0 out of 5 stars 16 reviews

A simple, straight-forward canthopexy will fix the asymmetry of your eyes

It appears from the picture as though the outside corner of your right eye (otherwise known as the lateral canthus) is slightly lower than that of the left eye. This is what's causing the asymmetry.

The issue can be quite simply addressed by releasing the attachments in this location and relocating the lateral canthus in a higher, more elevated position by means of subcutaneous suture techniques.

In this way, the fibrous tissue of the lateral canthus is fixed to the bone and the soft tissue attached to the bone (periosteum) in a more desirable position.

This simple procedure is known as a canthopexy.

Michael R. Macdonald, MD
Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 16 reviews

Eye asymmetry.

Your asymmetry is minimal and you should avoid surgery.  You are the only one who notices this and the risk of surgery is more than the gain. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 30 reviews

I recommend a consultation with a fellowship trained oculoplastic surgeon.

You photo is of poor quality but is appears that the left upper eyelid is droopy and the appearance of the left orbit is consistent with an unprepared orbit fracture.  This would be consistent with your history of facial trauma.  The American Society for Ophthalmic Plastic and Reconstructive Surgery, one of the professional organizations that endorses this site, maintains a geographic directory on their website that can help you identify a well qualified oculoplastic surgeon.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
5.0 out of 5 stars 22 reviews

Orbit [eye socket] asymmetry

The asymmetry you are describing is real, but subtle. THe issue is the underlying bony anatomy of the eye socket. This is a normal anatomic variant that is seen in many patients in varying degrees.

Though it is certainly possible that the trauma your are describing may be a factor, it is likely that this is a congenital issue; that is, your normal anatomy that your were born with.

If you really want to pursue this further, a CT scan of your maxillofacial region with 3D reconstruction will give you the anatomic answers you are looking for. I agree the surgery  required to address this maybe much more invasive than you may be willing to undergo, with a minor upside.

If you decide to explore this further, I would recommend consultation with an ASOPRS trained Oculoplastics surgeon. You can find one close to you on the ASOPRS dot org website. Alternatively,  a craniofacial surgeon [often found at Children's hospital's] may be a good resource as well.

Good luck


A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 30 reviews

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.