Too Much White Below my Eyes? (photo)

Question

I have very droopy lower eyelids. This is a picture of me looking straight ahead. Is there anything that could be done to correct this? Is it something I should even bother correcting? I have had eye issues my whole life. Terrible allergies, dry eyes, frequent infections, etc. However I am not sure that my "sanpaku" eyes have anything to do with it, or rather if this was caused by all the frequent issues I have with them.

Mehryar (Ray) Taban, MD, FACS · Answer

It is abnormal to see any white below your eyes (called scleral show). It is caused by lower eyelid retraction. It can be congenital (as in your case) or from trauma, surgery, thyroid eye disease, etc. It can cause your eyes to get more dry, resulting in irritation, tearing, etc. There are nonsurgical and surgical options available for elevation of the lower eyelids. See an oculoplastic surgeon.

Sam Goldberger, MD · Answer

I agree that you have too much white showing below your eyes (known as scleral show). There are two issues, one is functional and one is cosmetic. If you have symptoms consistent with the scleral show, then you might consider repair. If your issue is cosmetic, then you need an actual examination to see how involved the lifting would be. You should see an Oculoplastic surgeon who deals with this type of problem frequently.

Aaron Stone, MD · Answer

Your posted photo corroborates your findings of drooping lower eyelids and too much white showing below the irises. The outer corners of your eyes are lower than the inner corners which contributes to this. Lateral canthopexies to raise the outer corners should help but you first need a complete examination given your complaints of dry eyes your tear film and ducts need to be fully examined first.
	
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Vincent D. Lepore, MD (retired) · Answer

Scleral show, or droopy lower eyelids which result in the white of the eye showing below the iris, is not a uncommon problem. If the condition is more severe, it can result in eye irritation and even eye infections. In your case, the outer corners of your eyelid, the lateral cathus, is also somewhat low and is contributing to the problem. I agree with Dr Stone that a lateral canthopexy should help your situation. But, I too, would advise you to get a thorough medical exam to better evaluate your tear production and tear ducts before proceeding with any surgery. Best wishes.

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