Lazy eye or ptosis?
Ok, so I am trying to figure out what is wrong with my eye.
To me it looks like one is bigger than the other.
One of my eyelids has these small warts looking things that I cannot figure out what it is.
Please help.
Thank you for your question!
You submitted a photo and you’re inquiring about a concern you have regarding the different
shape of one eye compared to the other.
You also mentioned in your question the concern about a wart type of lesion and you want to
get more information as well.
Well, to give you a little bit about my background, I’m a cosmetic oculofacial plastic surgeon.
This means that my first area of specialty training was in eye surgery and then I went
on to do specialized training in cosmetic and reconstructive surgery of the eyelids,
the orbits, the lacrimal system.
These are the around the eyes.
I’m also board certified in full body cosmetic surgery by the American Board of Cosmetic
Surgery.
I’ve been in practice for over 20 years and I can certainly tell you that lesions
around the eyes and ptosis or drooping of the eyelids or asymmetry is something we deal
with every day in our practice.
So to begin with, when you present a question like this, the first thing I would say is
I would comment on what I see when I look at your photo.
When I looked at your photo, the left eye in the inner aspect appears to be lower than
compared to the right eye.
Now when you make an observation like this, you have to ask further in consultation.
In our practice, we ask about history, has it always been like this?
Did you look at previous photos of yourself and can you see that difference having been
present?
Sometimes when we look at patients, essentially what we’re trying to do is differentiate
is this drooping or ptosis and ptosis meaning drooping.
When we refer to the eyelid, its eyelid ptosis, we talk about a structure like the breast,
breast ptosis.
So in your case, eyelid ptosis on the left upper eyelid.
We want to differentiate is this congenital or in other words you were born with it or
is it acquired or something that has occurred later.
Let’s go with the understanding that you were born with this.
Now it has been our observation that patients who were born with the drooping eyelid, at
certain points of their life, their drooping eyelid can be a little bit lower.
Sometimes what they’ve done is they compensated for the asymmetry naturally and eventually,
there’s a little bit of a further descent.
Now this descent can only be a millimeter but it can make enough of a difference so
that you notice it.
Within the normal population, it’s normal to have a difference between the two eyelids
in terms of the difference of 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 attention from professional
opinion.
So without further information, I would say that you would need proper examination and
diagnosis but at least from the starting point, you have ptosis. 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 to acquired or typically what’s called myogenic ptosis
or muscle-related ptosis.
These are all different types of ptosis and there’s always a difference in the way you
approach 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, very often they’ll often see someone like
my specialty, an oculoplastic surgeon and try to determine what the cause is.
We also want to rule out neurologic causes.
Those are also things that patients will see an 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 and although I can’t
see exactly, it appears to be from a general perspective like a nevus or a bump like a
freckle that you’re born with.
Again, without a physical examination, without a 3 dimensional view, it’s really not appropriate
to just say that without qualifying it.
So again, meeting with a specialist is important to get the proper diagnosis.
So I hope that was helpful, I wish you the best of luck and thank you for your question!