Can My Right Eye Be Lifted Closer To The Position Of My Left Eye?

Q: Dr. Eppley, My eyes are uneven and I’m looking for something to help with it. Would you be able to help? Here is a picture for reference. Thank you! is a pic. Please let me know if he thinks he can bring one eye up higher and if he thinks I would look drastically different. Also, if you know the cost that would be great. Thank you so much!

A:Thank you for sending your picture. This is a classic case of aesthetic vertical dystopia (VOD) where the ride I is 3 to 4 mm lower than that of the left. It is important to understand that in VOD it is the entire orbital box and all of the overlying soft tissues that are lower. As a result it is not just lifting up the right eye only that will be successful. The lower eyebrow and upper and lower eyelids must be repositioned as well if the eye is moved up or otherwise the blog gets buried under the upper eyelid and a lot of scleral show above the lower eyelid.

As a result there is usually a five procedure approach to treating VOD. But the first and most important question is how much improvement can be obtained. Or will the surgical effort be worth it for the patient based on the outcome that can be achieved. That, of course, depends on each individual patient and how one defines the term ‘drastically different’. As a general statement it would be fair to say that achieving ideal symmetry of the right eye to the left cannot be obtained. Improvement or reduction in the amount of asymmetry is what is achievable and that is probably best defined as halfway between perfect symmetry and where the eye is now. Will you see a change… yes. Will it be ideal…. no.

The other way to think about the problem is what is the patient’s level of concern. If it is not overly bothersome and the inquiry about surgery is more explorative then I would not do the surgery. If it is a major issue of concern and the patient is willing to do about anything to get some level of improvement then the surgery would likely be worth it.

Dr. Barry Eppley

World-Renowned Plastic Surgeon