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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7854
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I realized a month ago that my left upper eye lid was much bigger than my right. Like if I

Resolved Question:

I realized a month ago that my left upper eye lid was much bigger than my right. Like if I were to put shadow on JUST my lid there would be three times as much on the left than on the right. It is fine or better every morning and throughout the day gets worse and worse. My eye is not red, no discharge, no pain. The lid is not puffy and the bone is obvious.. the lid almost looks sunken in.
Submitted: 3 years ago.
Category: Eye
Expert:  Dr. Rick replied 3 years ago.

Dr. Rick : Hi. I'm online and happy to answer your question today.
Dr. Rick :

I don't understand what you mean when you say that it seems like there is extra lid present, but the lid looks sunken in. How can there be more tissue but it is sunk in? Could you help to better understand what you mean?

Customer:

yes..

Customer:

the lid part near the lashes is about three times the size of the other one.. but the skin follows the contour of the bone..

Customer:

i can attach a picture.. it't hard to explain i guess

Customer:

i'm taking one to send

Dr. Rick :

ok. Let me check out the picture. brb

Dr. Rick :

Ok. It's true....a picture is worth a thousand words!

Dr. Rick :

Are you still there?

Customer:

yea.. i have no irritation or bacteria or anything.. but it's been this way for over a month

Customer:

its much much better in the morning but gets worse and worse throughout the day

Dr. Rick :

Can you take another picture that has the light shining on both eyes at once. The picture you sent has ?sunlight (you must be West of me :) on your left eye only...can you get it on both eyes, or if not, on the right eye so I can compare things a little better?

Customer:

yes i can..but it will take a min

Customer:

and i'm about as far west as you can get

Dr. Rick :

My sister lives in Santa Barbara.....California is a wonderful place. Only problem? It is filled with Californians =)

Customer:

lol

Dr. Rick :

working on the picture?

Dr. Rick :

ok....I didn't read the above...nevermind

Dr. Rick :

got it brb

Dr. Rick :

ok.....got two of the first one....brb

Dr. Rick :

Ok. Good pictures

Dr. Rick :

There is one of two things going on. Either one eye is being pulled back into your orbit a bit or the other one is being pushed out.

Customer:

i think its being pulled back.. but the eye seems normal..just the lid is getting sucked in

Dr. Rick :

There is an easy test your ophthalmologist can do with an instrument called a hertel exophthalmometer to determine if this is the case

Dr. Rick :

Your lids etc, as you said, look otherwise normal, as does your lid position.

Dr. Rick :

There can be a number of causes for this, from a vascular abnormality, swelling of the muscles around the eye (graves disease), nasty words (like tumors), etc. In any event, I agree with you -- there is a distinct difference in the tissue volume between your left and right orbit which is easy to see by your upper eyelid crease position.

Customer:

well i got referred to an ophthalmologist that specialized in surgery or something like that today..but they said it will take two months for the referral to go through

Customer:

so you think there is definately something causing it.. because a lot of people/drs have said..stress.. dehydration, allergies etc

Dr. Rick :

Dehydration would, in my mind, affect both orbits. Stress is the fall back reason, and that makes no sense to me. Allergies is a distinct possibility, and could affect one side only, but you didn't report any other allergy symptoms......I

Dr. Rick :

I'd feel more comfortable if you had an ophthalmologist give you a good going over and then, if nothing is found, blame it on stress, not being nice enough to your husband or boyfriend (or both ;) etc.

Customer:

so i guess i just need to wait two months for my referral to come through?

Dr. Rick :

I thought you were in the USA. Do you need a referral to see an ophthalmologist?

Customer:

i also have a piece of glass stuck in the same side of my head.. it's bundled up in a bunch of nerves..but it's from 6 years ago.. do you think it could be related?

Customer:

no.. my eye doctor put one through today..but i have to wait for them to schedule me

Customer:

i also just turned 30 on monday..that's why everyone is jumping straight to stress

Dr. Rick :

Two months seems like a long time to me. Do I think this is an emergency? No. But you would think you could get in within 4 weeks. Heck, I am the only retina specialist within aXXXXXand non-emergent patients can get into see me in just over 3 weeks.

Customer:

well i hope that's true.. she said all i can do is wait

Dr. Rick :

I graduated medical school when I was 30....so no sympathy from this side of the computer screen for being so "old" :o)

Customer:

the reasons you gave.. it would make sense that it would get better every morning and get bad every night?

Customer:

lol.. i'm not worried about it..they just all say i am

Dr. Rick :

I would put a vascular malformation higher on my list as possibilities due to that finding.....

Customer:

how do you fix that.. surgery?

Customer:

or you cant

Dr. Rick :

First you find where and why there is a malformation. Then, if needed, yes, surgery.

Customer:

its just so weird that it happened all of a sudden..

Dr. Rick :

These things do happen though. Thinking back do you thing it is that you are just noticing it more now? A good way to evaluate this would be to look at old pictures.

Customer:

i did.. it wasn't there before

Customer:

literally one day it happened

Dr. Rick :

Ya. It needs to be worked up. I'm glad you didn't buy the "it's stress" diagnosis.

Customer:

alright well i guess i'll just wait then

Dr. Rick :

Ok. One more thing. In the old pictures did both eyes look like the left one does now or the right one?

Customer:

right one

Customer:

i can send you an old pick

Customer:

*pic

Dr. Rick :

k

Customer:

my head's turned to the side in the shot.. so they do look a lil different from each other

Dr. Rick :

and the makeup is different too. Nothing gets past us eye docs =)

Customer:

lol

Dr. Rick :

It looks like your left eye has lost volume

Customer:

yea..but it did it over night which is what i don't understand.. my eye was really itchy the night it happened too..if that means anything

Dr. Rick :

Itchy makes one think of allergies, but then the area should swell, not sink in.....

Dr. Rick :

you need to be evaluated with a hertel exophthalmometer (great scrabble word, eh?) as there is a marked difference in the pictures. Stress doesn't cut it as an explanation.

Customer:

found something online called unilateral upper eyelid ptosis, google images has a lot of phots

Customer:

some look like my eye

Dr. Rick :

Ya, but your lid position in the pictures doesn't show ptosis. The lid margin of the upper and lower eyelid as compare to your pupil edge are the same on both sides. Not true in ptosis.

Dr. Rick :

and in the old picture you are smiling, so hard to tell, but looks about the same on both sides

Customer:

ahh.. cool.. well..thank you for your help.. i will wait for referral and hope for the best

Customer:

thanks for your time

Dr. Rick :

Sorry I couldn't figure it out for you...but the pictures really did help.

Dr. Rick :

And, now, the obligatory word from our sponsors: :o)


I hope that this information was helpful for you. Please, allow me get credit for my time and effort in assisting you and press the ACCEPT button for this assist. I will be glad to answer additional questions until you are satisfied. Thank you very much.

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Dr. Rick :

Just as an aside, what state are you in? I'm in Northern Wisconsin

Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7854
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
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