Q: Dr. Eppley, what can be done about my eye asymmetry? My whole left eye is about 5mms lower than that of my right eye. What is the best way to amend this problem?
A: To correct your orbital box eye asymmetry, multiple adjustments need to be made to the orbital floor (augmentation), brow bone (inferior reduction) as well as upper eyelid (ptosis repair) and lower eyelid (fat injections and lateral canthoplasty) The issue is that the bone changes will cause problems with the current eyelid positions and then these will need to be adjusted. I have treated many cases like yours and sometimes you open ‘pandora’s box’ by trying to make these changes. The position of the eyelids is perfectly aligned to the bony orbital skeleton now albeit lower and asymmetric that it is. Once changes get made to the orbital bony box, the eyelids will be off alignment to the globe (eyeball) and these realignments often take multiple surgeries to get the optimal result.
Once the horizontal level of the pupils differs by 5mms or more in eye asymmetry, attempts at surgical improvement are often met with mixed results and lead to multiple revisional procedures.
Dr. Barry Eppley