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One Eye Appears Larger Than the Other

Is One Eye Larger Than the Other?
Joel Kestenbaum, OD

Nobody is perfect.  I always thought I was until my wife set me straight……. but that’s another story.  The closest that anyone has ever come to being cosmetically perfect, at least according to the media, was Sophia Loren and Cary Grant back in the 1950’s and 1960’s.  For the rest of us, being close to perfection was the best we could do.

A common cosmetic imperfection in some people is when one eye appears larger than the other.  This imperfection is usually no medical concern if you were born that way.  One eye may look more rounded while the other looks narrower.  This may also happen if you become dehydrated.  But if this asymmetry develops over time, it may be an indication of a disease process.  It could have also occurred from an injury or spasm of the muscles surrounding the eye.  Most commonly, we see differences in eye size in people with high myopia (or nearsightedness) in one eye compared to the other, thyroid disease, tumors,  and droopy eyelids (ptosis).  Lets look at each one of these.

Myopia –  High levels of nearsightedness occurs as the eye elongates as it grows.  If myopia is unequal between the eyes, one eye might appear larger than the other.  You might even have a situation where the eye appears to be bulging.

Ptosis – Droopy eyelids can occur for many reasons including migraine headaches, eye infections, injury, normal aging, nerve issues and allergies.  Myasthenia Gravis is an autoimmune condition that sometimes presents itself by causing one or both eyelids to droop.  Often, optometrists are the first to discover that you have the disease.

Anisocoria – A condition where the pupil size of each eye differs.  In many cases, it may appear as if one eye is larger than the other, but it is just the size of the pupil.  If this condition existed for many years without changing, there is no worry.  If, however, this condition is relatively new, it could be due to a disorder of the eye or of the nerves, blood vessels or brain.  This needs to be investigated immediately.  In some cases, this can be a medical emergency.

Exophthalmos – Bulging eyes is common in overactive thyroid disease or in tumors of the eye.  One of the only ways to know whether this is longstanding or not is to look at old photographs.  You might have been imperfect from birth but have just come to realize it.  If, however. this is of new onset, a medical evaluation and comprehensive eye examination is warranted.  Grave’s disease can cause a swelling to the eyes as well as redness, dryness or watery eyes, soreness and blurry vision.  With treatment, it is possible that the eyes may return to a normal state.

Our team of Plainview based Long Island Eye Doctors are here to answer all questions that our patients may have.  We are fully equipped to diagnose and treat all red and irritated eyes and we are a resource for referrals if there is a more ominous problem.  Come see us before eye emergencies occur.  Routine care is always a good idea.

Dr. Joel Kestenbaum

www.optixeyecare.com

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