Why Are My Eyes Uneven, and Do I Need to Do Something About It?

Genetics are a common cause of asymmetrical eyes. Just like your other facial features, you’re likely to have features similar to that of your parents and other family members. If you look closely, chances are you’ll notice that others in your family also appear to have one eye that’s higher than the other.

The following are other possible causes of uneven eyes and their symptoms.

Enophthalmos

Enophthalmos is the posterior displacement of the eye and happens when an injury or medical condition changes the space behind the eye, causing the eye to sink. It can happen suddenly or gradually over years.

Trauma is the most common cause of enophthalmos, such as being struck in the face or hitting your face during a car accident. It can also be caused by a number of medical conditions, including those that affect the sinus cavity behind the eyes.

Some people experience no symptoms other than the sinking or drooping appearance of one eye. Depending on the cause, you may also notice a pulling sensation under the eye, sinus issues, or facial pain.

Conditions that can cause enophthalmos include:

• chronic maxillary sinusitis
• silent sinus syndrome
• Paget disease
• maxillary sinus tumors
• bony defects

Ptosis

Also called droopy eyelid, this condition can be present at birth (congenital) or develop later (acquired). Ptosis is more common in older adults. It happens when the levator muscle, which holds up your eyelid, stretches or detaches from the eyelid, causing it to droop. It causes the appearance of asymmetrical eyes, so one eye looks lower than the other.

In some people Ptosis affects both eyes. Aging is the most common cause of ptosis, but it can also be caused by neurological conditions, tumors, and stroke.

If the eyelid droops enough to interfere with your vision, surgery is recommended to correct it. Surgery can also be performed for cosmetic reasons if you choose.

Proptosis

Proptosis, which may also be referred to as exophthalmos, is the protruding or bulging of one or both eyes. Graves disease is the most common cause in adults. It makes the tissues behind and around the eye to swell, pushing the eyeball forward. Rarely, proptosis can also be caused by infections, tumors, or bleeding.

Along with a change in your eye’s appearance, you may also notice:

• eye pain
• pulsing in the pronounced eye
• fever
• vision problems

Normal facial asymmetry

Having perfectly symmetrical facial features is very rare. Most people have varying asymmetry in facial features that is considered normal. This also varies based on a your age, gender, and ethnicity.

Normal facial asymmetry can make one eye appear higher or lower than the other. Sometimes it’s not uneven eyes, but uneven eyebrows or the shape of your nose making your eyes appear uneven.

Aging is also a common cause of facial asymmetry. As we age, our skin and soft tissues lose elasticity which causes the skin around our facial features to sag.

A 2017 review of studies using hemifacial models, which show a person’s “unaltered” face alongside their perfect right-side symmetry and perfect left-side symmetry, have found that perfect facial symmetry is perceived as disconcerting and unattractive. Some facial asymmetry is not only normal, but also considered more desirable.

Treatment for uneven eyes isn’t usually needed. Unless there is an underlying medical condition that requires treatment or the asymmetry is interfering with your vision, treatment is a personal preference.

There are things that can be done to make your eyes appear more symmetrical, ranging from makeup tricks you can try at home to surgical and nonsurgical cosmetic procedures.

Makeup

You may be able to use makeup to make your eyes appear more symmetrical. Contouring, highlighting, and other techniques can be used to make certain features more prominent to create a look of balance.

An eyebrow pencil or powder can help even out the appearance of your brows, which may make your eyes appear even.

There are online video tutorials to help you do this. Many cosmetic and department stores have makeup artists and cosmeticians on staff that can show you how to use products to enhance your features.

Brow lift

Also called forehead rejuvenation or a forehead lift, a brow lift is a cosmetic procedure to raise your brows. It is performed by a cosmetic surgeon while under a general anesthetic. There are different surgical techniques that can be used to perform a brow lift, including:

• coronal brow lift
• endoscopic brow lift
• hairline brow lift

As with any surgical procedure, there are potential risks including infection, bleeding, and scarring.

Botox

Botox can sometimes be a used as a temporary fix for uneven eyes. Many times, it’s a person’s eyebrows that are asymmetrical and cause the eyes to appear uneven. Brow asymmetry is common. Botox provides a nonsurgical option to a brow lift.

Botox, which is an injectable muscle relaxer, can be injected into the area around the brow so that it becomes relaxed to help create a look of balance. Results generally last around four months.

Blepharoplasty

Blepharoplasty is the cosmetic surgery used to correct uneven eyelids. The procedure doesn’t make your eyes symmetrical, but can make them appear even if excess fat or skin is causing your eyes to appear asymmetrical.

During the procedure, excess tissue, such as fat, muscle, and skin, is removed from your upper or lower eyelids. Bruising and swelling is common and lasts approximately two weeks. Incision scars can take several months to fade.

Orbital surgery

Orbital surgery is surgery of the orbit, which is your eye socket. The orbit is comprised of four walls of bone, your eyeball, eye muscles, optic nerve, and fat.

There are different surgical procedures that are used to treat trauma and medical conditions affecting this space. This can include surgery to repair fractures or remove tumors, or orbital decompression surgery which is used to treat exophthalmos caused by Graves disease and infections.

Do nothing

Unless asymmetrical eyes are caused by a medical condition or causing vision problems, treatment is not necessary. In this case, treatment is for cosmetic purposes and based on personal choice.

If you’re experiencing vision problems or other symptoms, such as eye pain, swelling, or a pulsing sensation in one eye, speak to a doctor about referral to an ophthalmologist. If your eye’s appearance changed because of a trauma or injury involving the head or face, go to the emergency room.

Uneven eyes are considered normal and rarely a medical concern. We tend to be most critical of ourselves, but chances are that no one else has noticed the asymmetry. If you’re concerned about what’s caused your asymmetry or are experiencing other symptoms, speak to a doctor.