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Am I experiencing Hering's Law after ptosis surgery?

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peanut2015Jun 15, 2015

I had unilateral ptosis surgery a few weeks ago and now the non-operated eye looks droopy. My doctor said my eyes may take awhile to "even out" but I am worried they should be more symmetrical by now. Will this resolve itself or will the now droopy eye need to be operated on as well? If it does resolve itself, how long does it usually take after surgery to look symmetrical?

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Dr. John J. Martin, Jr., MD
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Dr. John J. Martin, Jr., MD
Oculoplastic Surgeon, Board Certified in Ophthalmology
5.0 | 53 Reviews
Answered on Jun 16, 2015
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Dr. Kenneth D. Steinsapir, MD
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Dr. Kenneth D. Steinsapir, MD
Oculoplastic Surgeon, Board Certified in Ophthalmology
4.8 | 79 Reviews
Answered on Jun 16, 2015
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Dr. Steven Wallach, MD
Dr. Steven Wallach, MD
Board Certified Plastic Surgeon
Answered on Jun 16, 2015
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Mehryar (Ray) Taban, MD, FACS

The answer depends if the droopiness is causing problems right now (either blocking vision or causing head to move back).  You have to see a pediatric ophthalmologist along with an oculoplastic specialist. If it is not causing problem, then best to wait until teenage years.

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John J. Martin, Jr., MD

The swelling should not affect the final outcome.  However in the short term it may actually make the lid look lower since the weight of the swelling can pull the lid down.  If it was even post-op it would be unusual for it to fall at 3 weeks, but it can.  If still swollen give it...

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Kenneth D. Steinsapir, MD

However, there are a few other things going on.  There is a bit of facial asymmetry so the left eye appears to sit a bit lower in the face than the right eye.  Also in the second picture, it looks like the left pupil is smaller than the right pupil.  If that proves to be the case...

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Kenneth D. Steinsapir, MD

Looking at your photos, I suspect that the left upper eyelid ptosis is likely something that would qualify for coverage under many health insurance plan.  If you have no insurance, perhaps you can seek care at County Hospital if there is one in your community.  If you have health...

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Kenneth D. Steinsapir, MD

There is a list of issues that can cause a traumatic horner's syndrome. Generally, the ptosis is correctable with a conjunctival Muellerectomy.  However, there is also a pupil abnormality associated with the Horner's syndrome and this cannot be corrected surgically.  I recommend you...

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