How Can My Eye Asymmetry Be Treated?

Q: Dr. Eppley, About four years ago, while trying on glasses, I had my wife take a picture to see how I looked with a particular pair. For the first time, I noticed that one of my eyes was positioned slightly lower than the other. I’d never been aware of this asymmetry, and the discovery was quite shocking.

Since then, I’ve become increasingly sensitive to social interactions, noticing how often people avoid making eye contact with me. This has highlighted past experiences where I felt self-conscious but couldn’t pinpoint the reason. Realizing there was a noticeable asymmetry in my eye alignment has helped me understand some of those experiences. Unfortunately, this awareness has also impacted my self-confidence, causing me to avoid social settings and become more introverted.

I’m reaching out to discuss potential corrective procedures to address this vertical asymmetry. I’ve attached a photo showing that one eye sits slightly lower than the other. I’ve read about treatments like orbital floor implants and other corrective procedures and would like to know if options are available that could help restore my confidence.

Thank you for your time and consideration.

A:In assessing vertical orbital dystopia (VOD) the first thing I look is the amount of vertical discrepancy. In adults and non-craniofacial syndromic VOD (what I call aesthetic VOD) the key is whether camouflage techniques (e.g., custom orbital floor-rim-cheek implant, – a non-orbital box osteotomy approach) can be effective. This usually has to be a VOD that is 5mms or less in vertical discrepancy. That appears to be your case so it worth investigating potential VOD corrective surgery. The next step is to evaluate ‘internally’ the differences in shape and position of the orbital boxes. This requires a 3D CT scan which can be done in your geographic area and we place the order for it. That should be obtained before a virtual consultation so that time is more meaningful for treatment evaluation and planning.

Dr. Barry Eppley

World-Renowned Plastic Surgeon