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Ask Dr. A.S. Desai Your Own Question
Dr. A.S. Desai
Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2437
Experience:  MS Ophthalmology with 13 years of surgical expereince
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For the last 3 years or so, I've been dealing with what

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For the last 3 years or so, I've been dealing with what seems to be a drooping lower eyelid on my right eye. I'm not sure if it's Ptosis or if the eye has become bigger than the other one, but it seems to have gotten worse. Can someone fill me in on what it probably is and what my options are?
Here are pictures for your reference:
http://img.photobucket.com/albums/v223/rocknskadude/photo3-1.jpg
http://img.photobucket.com/albums/ v223/rocknskadude/photo4-1.jpg
http://img.photobucket.com/albums/v223/rocknskadude/photo2-2.jpg
http://img.photobucket.com/albums/v223/rocknskadude/photo1-3.jpg
Dr. A.S. Desai :

Hello, Welcome to Pearl.com

Customer:

Hello

Dr. A.S. Desai :

Are you available for chat now?

Customer:

yes

Dr. A.S. Desai :

I did view the images you sent and it does look like the palpebral fissure is wider in the right eye.

Dr. A.S. Desai :

How is the vision in the right eye? Is it as good as the left eye? Are both having 20/20 vision?

Customer:

yes, I'm near sighted and wear glasses/contacts, but vision is pretty much the same in both

Customer:

and was tested just a few weeks ago and was told no eye problems

Customer:

aside from what seems to be a drooping eyelid

Dr. A.S. Desai :

It does not look like drooping of the lower lid but the scleral show ( excessive white tissue seen in the lower part) could be due to a larger axial length in the right eye as compared to the left eye.

Dr. A.S. Desai :

One of the reasons why short sightedness occurs is due to a larger eyeball from a longer axial length of the eyeball.

Customer:

so essentially, my right eye is bigger than the left?

Dr. A.S. Desai :

This can be confirmed by getting the axial length measured with the help of an A scan.

Customer:

but i've dealt with short sightness my whole life

Dr. A.S. Desai :

Yes, it looks like the right eye is larger than the left eye.

Customer:

and i havent had this problem my whole life

Customer:

only last few years, and again, recently seems worse

Customer:

so it's not a drooping eyelid causing all the white to show? It's simply because the eye is bigger?

Dr. A.S. Desai :

Even if the short sightedness has been there since your childhood, it might become obvious during adulthood. It is in the mid twenties that the growth of the eye kind of settles down ( with no more growth of the eyeball , so no more change in its axial length).

Customer:

but again, the right eye problems began a few years ago and just within the last few months or so, seemingly have gotten a lot worse

Customer:

are there treatment options?

Dr. A.S. Desai :

There can be other causes for the scleral show too such as thyroid eye disease but can only be confirmed by blood tests for thyroid hormones.

Dr. A.S. Desai :

You said you were tested a few weeks ago. Were you examined by an ophthalmologist or an optician?

Customer:

opthmalogist

Customer:

but i live in japan, so the opthmalogists here aren't very skilled

Customer:

she simply said my eye was "tired" and prescribed eye drops

Customer:

a few years ago, when i first noticed the problem but it wasn't so bad, i had my thyroid checked and it came back fine

Customer:

but again, recently seems much worse

Dr. A.S. Desai :

Since the changes have been recent, I think it is wiser to repeat the thyroid tests.

Dr. A.S. Desai :

Apart from that an ultrasound of the right eye along with a measure of its axial length would help to identify the problem.

Customer:

if they come back okay, are there treatment options to correct the asymmetry?

Dr. A.S. Desai :

Without these tests it would be difficult to identify the problem.

Dr. A.S. Desai :

If the tests came back fine ( no thyroid problem), then it would probably be due to a larger right eye. In that case there are no surgical options for correction of the asymmetry.

Customer:

even just raising the lower eyelid to cover the white?

Dr. A.S. Desai :

Cosmetic correction of the lower lid can be tried ( provided there is some amount of lid laxity wherein lid shortening procedure can be tried). But of course this is not the recommended treatment for this.

Customer:

okay.....so essentially, if it's not thyroid, i'm recommended to just leave it alone?

Dr. A.S. Desai :

yes, after the tests are done.

Customer:

alright, thank you

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