Lazy eye or ptosis? (Photo)
Doctor Answers 6
The most obvious thing, as others have noted, is the ptosis (or "drooping") of the left upper lid compared to the right side. The upper lid crease is also higher on the left, commonly seen when a lid is droopy. The other asymmetric finding I see is that there is more "white" showing above the left lower lid (compared to no "white" showing on the right). Since your lower lids look to be in similar positions, this could be due to a difference in the position of the eyeball itself. The combination of these findings lead to the overall asymmetry.
My recommendation would be to see an oculoplastic surgeon for a detailed exam to more thoroughly investigate these issues. Surgically repairing the droopy lid alone may sufficiently address the asymmetry. Your surgeon will give his/her opinion and discuss with you all of your options.
You likely have ptosis, but you do need a physical evaluation by a specialist to determine its specific cause and treatment
When I looked at your photo, the left eye in the inner aspect appears to be lower compared to the right eye. When we make observations, we want to ask further questions in a consultation. In our practice, we ask about history and if you looked at previous photos and saw that difference. We try to differentiate if this drooping is congenital or you were born with it or if it is acquired or something that has occurred later.
If you were born with the drooping eyelid, at certain points of your life, that drooping eyelid can be a little lower. Sometimes patients compensate for the asymmetry naturally, which eventually leads to a bit of a further descent. This descent can only be a millimeter but it can make enough of a difference. Within the normal population, it’s normal to have a difference between the two eyelids of about 1-2 millimeters. The human body is asymmetric so we generally tolerate that without it drawing attention. When it’s greater than that, it usually prompts people to seek professional attention.
I would say that you would need proper examination and diagnosis. In my practice for over 20 years, I have performed all kinds of ptosis surgeries from congenital or people born with it, for helping people with vision, acquired ptosis, myogenic ptosis or muscle-related ptosis. These are all different types of ptosis and there’s always a difference in the way you approach them based on some objective parameters that are determined during physical examination. So clearly, you need to meet with a doctor in order to get the proper evaluation of this concern.
Generally, people first see an ophthalmologist or someone from my specialty, an oculoplastic surgeon and try to determine what the cause is. We also want to rule out neurologic causes which can be determined by a neuro ophthalmologist. As long as you find one specialist to evaluate you, you should be led from that one point forward in the right direction.
As far as the lesion is concerned, although this is not a high resolution photo, I believe you are referring to a lesion in left lower eyelid along the margin. Although I can’t see exactly, it appears to be from a general perspective a nevus or a bump-like a freckle that you’re born with. Again, without a physical examination and without a 3-dimensional view, it’s really not appropriate to diagnose that without qualifying it. Again, meeting with a specialist is important to get the proper diagnosis. I hope that was helpful, I wish you the best of luck, and thank you for your question.
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Seek out a board certified oculofacial plastic surgeon in your area for this type of delicate surgery.
I hope that helps and best of luck.