Asian eye one big one small, is this ptosis, and what can be done? (photo)

First and foremost, if the drooping of your left eyelid (as it appears in the photo) is something that you’ve always had, then we refer to that as congenital ptosis. Ptosis means drooping, and congenital refers to something that you were born with.When dealing with congenital ptosis, it is important to understand that ptosis has an enormous impact on vision, especially for children aged 0-6 years old. During these early years, proper visual development requires the projection of a clear image onto the eyes. If this is in any way impaired, then the vision does not fully develop and you’re left with what is referred to as “lazy eye” or what we call medically as amblyopia. Amblyopia by definition is the permanent decrease in vision due to neurologic development secondary to a lack of clear image being projected on the retina.Your case may be amblyopia, but in order to determine that, you will need to have a full ophthalmic assessment by a pediatric ophthalmologist, and also have them evaluate the potential of vision in your weaker left eye.Ptosis itself, however, is curable depending on two important factors: the degree of ptosis and muscle function. The degree of ptosis refers to the position of the eyelid (how low it is) in relation to the center of the eye, or the pupil; while muscle function refers to the strength of the muscle responsible for lifting the eyelid—the levator muscle. With congenital ptosis, the levator muscle doesn’t develop fully. In other words, this muscle neither contracts fully as a normal muscle does, nor does it relax fully. By looking at these two factors, we can determine what the best surgical option is for you.In my practice, ptosis surgery is routinely performed on adults, though I have performed this procedure on patients as young as 14-years-old. Ptosis surgery is a dynamic procedure that involves a lot of technique, and oftentimes, we’ll ask our patients to cooperate with us by having them sit up during the procedure, so that we can better achieve the optimal height, shape and contour for their eyes. In summary, I think the ideal way to go is to meet with an ophthalmologist, have your eyes examined and get some information about your visual potential, and then be sure to meet with specialist such as an Oculoplastic or Oculofacial plastic surgeon, who routinely deals with ptosis cases. I hope that was helpful, I wish you the best of luck, and thank you for your question. This personalized video answer to your question is posted on RealSelf and on YouTube. To provide you with a personal and expert response, we use the image(s) you submitted on RealSelf in the video, but with respect to your privacy, we only show the body feature in question so you are not personally identifiable. If you prefer not to have your video question visible on YouTube, please contact us.

You may or may not have true ptosis.  The difference in vision on the 2 sides may or may not be related to the eyelids.  When it comes to surgical correction of your asymmetry the prescription of your vision could change or it may not.  In your particular case if you have pseudoptosis you do not have to repair the tendon called the levator aponeurosis.  Nearly 40% of my Asian eyelid surgery practice is for asymmetry and much of that is pseudoptosis.  I also repair a lot of Asian eyelid ptosis which is a little more complicated and invasive but it is a very practical surgery to do in the hands of an experienced specialist.See the attached video for more information.  The web link attached has more than a few examples of eyelids similar to yours.Chase Lay, MDAsian eyelid surgery specialists

From this one photograph, it is difficult to assess your situation. It is clear there is an asymmetry but the underlying cause needs to be determined. To that end, you would benefit from an in person evaluation by a board certified surgeon with expertise in Asian blepharoplasty.