I was born like this I have not had surgery or any problems with my eyes. This is for cosemtic reasons only. Too much of the whites show at the bottom of my eyes and it make my eyes look different and I would like to know if this can be fixed?
Answer: Scleral show The eyelids are slightly lower than the usual position. This can be left alone. If it is very disturbing to you, a small procedure can be performed to elevate the lids upward. See an eyelid surgery specialist (oculoplastic surgeon) in office for better evaluation and treatment plan.
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Answer: Scleral show The eyelids are slightly lower than the usual position. This can be left alone. If it is very disturbing to you, a small procedure can be performed to elevate the lids upward. See an eyelid surgery specialist (oculoplastic surgeon) in office for better evaluation and treatment plan.
Helpful 3 people found this helpful
Answer: Excess Scheral Show Your pictures suggest the presence of scleral show in someone who otherwise has attractive eyes. Although your pictures are helpful, the angle of the camera can sometimes cause distortion. For this reason, it's important to be evaluated by someone who's experienced performing eyelid surgery.Excess scleral show can occur for a variety of reasons. The successful treatment of this problem is, therefore, dependent upon an accurate assessment of the causation. Once this determination has been made, a variety of treatment options are available. These include canthopexy procedures that elevate the position of the lower eyelid.If you're considering treatment of excess scleral show, it's important to consult a board certified plastic surgeon with experience performing this type of procedure. This surgeon should be able to formulate a treatment plan that addresses your anatomic findings and aesthetic goals.
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Answer: Excess Scheral Show Your pictures suggest the presence of scleral show in someone who otherwise has attractive eyes. Although your pictures are helpful, the angle of the camera can sometimes cause distortion. For this reason, it's important to be evaluated by someone who's experienced performing eyelid surgery.Excess scleral show can occur for a variety of reasons. The successful treatment of this problem is, therefore, dependent upon an accurate assessment of the causation. Once this determination has been made, a variety of treatment options are available. These include canthopexy procedures that elevate the position of the lower eyelid.If you're considering treatment of excess scleral show, it's important to consult a board certified plastic surgeon with experience performing this type of procedure. This surgeon should be able to formulate a treatment plan that addresses your anatomic findings and aesthetic goals.
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August 28, 2012
Answer: My recommendation is to leave it alone
My initial reaction would be to leave your eyes as they are. However, if you want a second opinion, I sometimes refer patients with your concern to a colleague across the street from my office in New York City.
His name is Dr. Glen Jelks, and he may have had experience with your problem before.
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August 28, 2012
Answer: My recommendation is to leave it alone
My initial reaction would be to leave your eyes as they are. However, if you want a second opinion, I sometimes refer patients with your concern to a colleague across the street from my office in New York City.
His name is Dr. Glen Jelks, and he may have had experience with your problem before.
Helpful
September 25, 2016
Answer: Midface issue Dear Shonrea, A full face photograph would be very helpful as how you position your face will have an effect on the degree of white showing under the colored portion of the eye. This show of white is called inferior scleral show. Normally, the lower eyelid margin rides the eye just at the inferior limbus. The limbus in the circle defined on the eye where the colored portion of the eye meets the white portion of the eye. So yes, it is true that your lower eyelid rides very low on the eye. Another way of thinking about this issue is that the eye is very prominent relative to the projection of your cheek bone. Now to understand the issue a little more fully, it is important to understand a little bit about the geometry of curved objects like the surface of the eye. When a plane flies form say Los Angeles to London, the pilot does not fly a straight line from one city to the other. This is because on a spherical object like our planet earth, the shortest distance between to points is not a straight line but rather a curved line, called a geodesic. So the pilot flies what is called a polar route between Los Angeles and London. This curved path follows a geodesic arch between these two cities which defines the shortest distance between these cities. The same phenomena is important to understand when it comes to eyelid surgery because the eye is not flat but instead is spherical. You may consult plastic surgeons who offer to perform a procedure called a canthopexy or canthoplasty. These are slightly different procedures that involve tightening or shortening the eyelid with the intent of lifting the lid margin higher up on the eye. Well this will not only not work, but this will actually force the eyelid to ride even lower on the eye due to the spherical shape of the eye. It is kind of like what happens when someone tightens their belt and the pants and belt slide under the fullness of the belly. Ouch. As a result of this under appreciated geometry, as you can image, a lot of well meaning plastic surgeons run into a lot of trouble with this type of lower eyelid surgery. I end up fixing these types of problems. In your case, you have not had surgery, this is how you come and it is the relative position of your eye to the edge of the cheek bone that accounts for this situation. It is helpful for someone like yourself to explore how much lower eyelid elevation you will tolerate. Recognize that big eyes are considered to be beautiful. When the eyelid is lifted up, the eyes will be perceived to be smaller. It is important as part of the consultation to explore the happy balance between the apparent bigness of the eyes and the desire to have the eyelid cover more of the eye. In terms of how to actual raise the lower eyelid, it is important to elevate the cheek. In your case with means improving the projection of the cheek bone at the orbital rim. I do this with a swinging eyelid approach working primarily behind the lower eyelid so there is virtually no skin incision. A custom hand carved ePTFE orbital rim implant is made at the time of surgery and this extends the projection of the orbital rim. Next the cheek is lifted onto this implant. The lower eyelid needs to be lengthened across the entire eyelid. This is done by using hard palate graft from the roof of the mouth. Finally the canthal angle is reformed and the eye is sewn closed for 1 week. The other side is done at a separate surgery one week later. Obviously this is a very big undertaking.
Helpful 3 people found this helpful
September 25, 2016
Answer: Midface issue Dear Shonrea, A full face photograph would be very helpful as how you position your face will have an effect on the degree of white showing under the colored portion of the eye. This show of white is called inferior scleral show. Normally, the lower eyelid margin rides the eye just at the inferior limbus. The limbus in the circle defined on the eye where the colored portion of the eye meets the white portion of the eye. So yes, it is true that your lower eyelid rides very low on the eye. Another way of thinking about this issue is that the eye is very prominent relative to the projection of your cheek bone. Now to understand the issue a little more fully, it is important to understand a little bit about the geometry of curved objects like the surface of the eye. When a plane flies form say Los Angeles to London, the pilot does not fly a straight line from one city to the other. This is because on a spherical object like our planet earth, the shortest distance between to points is not a straight line but rather a curved line, called a geodesic. So the pilot flies what is called a polar route between Los Angeles and London. This curved path follows a geodesic arch between these two cities which defines the shortest distance between these cities. The same phenomena is important to understand when it comes to eyelid surgery because the eye is not flat but instead is spherical. You may consult plastic surgeons who offer to perform a procedure called a canthopexy or canthoplasty. These are slightly different procedures that involve tightening or shortening the eyelid with the intent of lifting the lid margin higher up on the eye. Well this will not only not work, but this will actually force the eyelid to ride even lower on the eye due to the spherical shape of the eye. It is kind of like what happens when someone tightens their belt and the pants and belt slide under the fullness of the belly. Ouch. As a result of this under appreciated geometry, as you can image, a lot of well meaning plastic surgeons run into a lot of trouble with this type of lower eyelid surgery. I end up fixing these types of problems. In your case, you have not had surgery, this is how you come and it is the relative position of your eye to the edge of the cheek bone that accounts for this situation. It is helpful for someone like yourself to explore how much lower eyelid elevation you will tolerate. Recognize that big eyes are considered to be beautiful. When the eyelid is lifted up, the eyes will be perceived to be smaller. It is important as part of the consultation to explore the happy balance between the apparent bigness of the eyes and the desire to have the eyelid cover more of the eye. In terms of how to actual raise the lower eyelid, it is important to elevate the cheek. In your case with means improving the projection of the cheek bone at the orbital rim. I do this with a swinging eyelid approach working primarily behind the lower eyelid so there is virtually no skin incision. A custom hand carved ePTFE orbital rim implant is made at the time of surgery and this extends the projection of the orbital rim. Next the cheek is lifted onto this implant. The lower eyelid needs to be lengthened across the entire eyelid. This is done by using hard palate graft from the roof of the mouth. Finally the canthal angle is reformed and the eye is sewn closed for 1 week. The other side is done at a separate surgery one week later. Obviously this is a very big undertaking.
Helpful 3 people found this helpful
July 21, 2015
Answer: Excessive white showing of the eyes Your eyes are unique in that the upper portion of the pigmented portion of the eye is covered by the lid, while the lower portion shows a fair amount of white (sclera). This is a variant of a normal eye configuration. If the amount is objectionable or causes dry eye syndrome, it can be corrected. Your picture was not taken at a completely straight angle, and patients looking upward, especially patients with a prominent globe, will appear to have a problem worse than it actually is. First, the patient has a medical evaluation to make sure they do not have a medical reason for the globe being prominent, for example the thyroid gland being too active. In our experience, a canthopexy (upward tightening of the corner of the eye) alone can produce an oddly shaped eye, with a severe uptick at the corner of the eye while the central portion of the lower eyelid remains low, producing a catlike appearance. We prefer, when surgery is warranted, to perform a cheeklift with a lateral only ultrashort incision (USIC), elevate the midface and along with it the center of the lower eyelid, to produce a more almond shaped eye. When combined with a canthopexy, this can produce a more natural eye appearance while minimizing the tendency toward scleral show. Your eyes will always be your eyes to some extent, so the goal of the surgery will be to reduce, but not eliminate the scleral show. This procedure is technically complex and we urge patients not to undergo it unless there is a clear reason to do surgery.
Helpful 2 people found this helpful
July 21, 2015
Answer: Excessive white showing of the eyes Your eyes are unique in that the upper portion of the pigmented portion of the eye is covered by the lid, while the lower portion shows a fair amount of white (sclera). This is a variant of a normal eye configuration. If the amount is objectionable or causes dry eye syndrome, it can be corrected. Your picture was not taken at a completely straight angle, and patients looking upward, especially patients with a prominent globe, will appear to have a problem worse than it actually is. First, the patient has a medical evaluation to make sure they do not have a medical reason for the globe being prominent, for example the thyroid gland being too active. In our experience, a canthopexy (upward tightening of the corner of the eye) alone can produce an oddly shaped eye, with a severe uptick at the corner of the eye while the central portion of the lower eyelid remains low, producing a catlike appearance. We prefer, when surgery is warranted, to perform a cheeklift with a lateral only ultrashort incision (USIC), elevate the midface and along with it the center of the lower eyelid, to produce a more almond shaped eye. When combined with a canthopexy, this can produce a more natural eye appearance while minimizing the tendency toward scleral show. Your eyes will always be your eyes to some extent, so the goal of the surgery will be to reduce, but not eliminate the scleral show. This procedure is technically complex and we urge patients not to undergo it unless there is a clear reason to do surgery.
Helpful 2 people found this helpful