What is Eye Asymmetry?
What is Eye Asymmetry? Asymmetrical or uneven eyes are practically normal but surgery and treatment options can help. For that reason, treatment can be very subtle or very obvious to the patient. The eye asymmetry could become more apparent when smiling or tired depending on the cause. When the difference between the two eyes is more obvious, it can become bothersome to the patient.
Eye asymmetry size can be caused by many factors. True eye asymmetry size (one eyeball being bigger or smaller than the other) is rare but can happen. Most commonly, the eye asymmetry is an illusion due to eyelid asymmetry, eyeball position asymmetry, and/or orbit (eye socket). A detailed Oculoplastic exam is necessary to determine the cause and the possible treatment for asymmetrical eyes. Contact Dr. Taban in Beverly Hills to schedule a consultation today.
Eyelid or Eye Asymmetry Treatment Options
Another common cause of eye asymmetry is asymmetric upper eyelid ptosis (droopy upper eyelid). Due to, the eye with the droopier eyelid appears smaller. Furthermore, there are various causes of upper eyelid ptosis. One of the best treatment options is ptosis droopy eyelid surgery.
*See disclaimer below
Before eye asymmetry due to right upper eyelid ptosis. After right upper eyelid ptosis repair with improved eye symmetry.
Before eye asymmetry due to right upper eyelid ptosis. After right upper eyelid ptosis surgery with improved eye symmetry.
Eye Asymmetry – Upper Eyelid Retraction
Another, cause of eye asymmetry size, is upper eyelid retraction. For the reason that, the upper eyelid is higher than normal, where the eye appears bigger than the other eye. Upper eyelid retraction could be congenital/inherited due to thyroid eye disease, postsurgical, etc. In many cases, the best treatment option is upper eyelid retraction surgery.
Before eye asymmetry due to mild right upper eyelid retraction. After right upper eyelid retraction surgery with improved eye symmetry.
Before obvious eye asymmetry due to left upper eyelid retraction and right upper eyelid ptosis. After left upper eyelid retraction surgery and right upper eyelid ptosis surgery with improved symmetry.
Eye Asymmetry – Lower Eyelid Retraction
If one lower eyelid is lower than the other eye, then that eye would appear larger. There are various causes of lower eyelid retraction including congenital/inherited, post-blepharoplasty eyelid retraction, and post skin cancer surgery. Treatment usually involves elevating the lower eyelid, through hidden transconjunctival approach with possible midface/soof lift and/or internal spacer graft.
Eye asymmetry due to right lower eyelid retraction with sclera show.
After – bilateral lower eyelid retraction surgery, right side greater, with improved eye symmetry.
Before obvious eye asymmetry due to severe left lower eyelid retraction. After left lower eyelid retraction with improved eye symmetry.
Eye Asymmetry (Eyebrow)
If one eyebrow is higher or lower than the other, that can make the eyes look asymmetrical. Eyebrow position is determined by genetics, facial bony structure, muscle/nerve function, and underlying eyelid. For instance, a droopy upper eyelid (ptosis) can cause the same side eyebrow to elevate in order to assist lift the droopy eyelid.
Before eye asymmetry due to uneven eyebrows with right side higher. After asymmetric botox injection to make brows evener.
Middle age woman, with both eyelid and eyebrow asymmetry, underwent asymmetric botox injection to create more symmetric eyes.
If there is more hollowness around one eye, that can cause the eyes to look asymmetric. Treatment could be non-surgical eyelid filler injection or fat injection. Learn more about eyelid filler injection.
Before eye asymmetry due to left upper eyelid hollowness. After left upper eyelid filler injection with improved eye symmetry.
41 year old male, complained of eye asymmetry and looking tired which is due to left upper eyelid ptosis (droopy upper eyelid) and upper eyelid hollowness along with under eye bags. He underwent internal left upper eyelid ptosis surgery and bilateral upper eyelid-brow filler injection, along with transconjunctival lower blepharoplasty with fat repositioning. No skin was removed from any of the eyelids. Before and 6 weeks after cosmetic eyelid surgery and upper eyelid filler injection photos are shown. (After photo is a selfie.)
Asymmetric eyelid contours can also lead to eye asymmetry as this photo depicts.
Asymmetric eyes due to uneven lower eyelid contours and positions.
Video showing young woman with upper eye asymmetry who undergoes right upper blepharoplasty and left upper eyelid filler injection with improved upper eyelid symmetry.
Eyeball Position or Orbit Eye Asymmetry – Proptosis
If one eyeball is more bulging (protruding) than the other eyeball, it will make the eye appear larger. Also, there are various causes of bulgy eyes including genetic and inherited. In contrast, Graves thyroid eye disease, shallow eye socket, and flat upper cheekbone can cause bulgy eyes. Above all, a bulging eye can be treated via orbital decompression surgery to make the eyeball go back.
Eye asymmetry due to bulging eyes, right side worse. After bilateral orbital decompression, right side more, and lower eyelid retraction.
Eye Asymmetry – Enophthalmos (Sunken Eye)
Another related cause of eye asymmetry is if one eyeball is more sunken than the other eyeball. Certainly, enophthalmos makes the eye appear smaller. As a result, there are various causes including genetic/inherited, prior orbital blowout fracture, and silent sinus syndrome. So, the cause of Enophthalmos needs to be determined and treated. Maybe, orbital implant placement treatment can be used to push the eyeball forward.
Eye asymmetry due to left Enophthalmos or sunken eye from orbital fracture making left eye appear smaller. After left orbital implant placement with an improved eye.
Obvious eye asymmetry due to the right sunken eye. After right orbital implant placement with improved eye.
Eye Asymmetry – Orbital Asymmetry
If the orbits (bony eye socket) are positioned differently in the facial bone (skull), then that can cause subtle to very obvious eye asymmetry with one eye being higher or lower than the other eye. Certainly, treatment could consist of altering the eyelid position (through eyelid surgery) and/or eyeball position. Likewise, treatment through customized orbital decompression and/or orbital implant. Expert evaluation with a CT scan of orbits is needed for proper assessment and treatment.
Eye asymmetry due to right orbit and eyeball higher than the left eye.
Eye asymmetry due to right eyeball higher than the left. After right customized orbital decompression to lower right eyeball, with improved eye symmetry.
55-year-old female, complained of eye asymmetry with right eye lower than left eye. She underwent right orbital floor implant and left upper eyelid filler injection to improve her eye symmetry. Before and 3 months after eye plastic surgery photos are shown.
*Disclaimer: Results vary from patient to patient. Results are not guaranteed.
Eye asymmetry with right eyeball more bulging and lower than left eyeball and orbit.
Eyeball size asymmetry causes (rare): microphthalmos, buphthalmos, high myopia.
Next, read about Eyelid Skin Cancer Surgery and Eyelid Reconstruction.