One Eye Bigger Than The Other

If you’ve noticed a drastic difference or sudden change in your eye symmetry, schedule an appointment with your eye doctor right away. But if you’ve always had an eye that looks a little different from the other, you may be seeking tips on how to cosmetically fix asymmetrical eyes.

Asymmetrical eyes: Causes, treatments and tips

The terms “asymmetrical eyes” and “uneven eyes” typically refer to eyes that are different shapes, sizes or even colors. One eye may sit higher or lower than the other, open wider or narrower than the other, or sit further back in the eye socket.

A review of literature found that faces that seem too perfect — or too symmetrical — can actually make people feel uncomfortable. Thus, some degree of facial asymmetry may be preferable.

But in some cases, eyes that look different may be caused by an eye issue or health problem. If your eyes aren’t even, it’s important to have your eyes examined by a doctor to determine the cause for their asymmetric appearance and determine whether treatment is needed.

What causes eye asymmetry?

Many people with eye asymmetry were simply born with uneven facial features. For many, it isn’t a problem or anything that needs to be fixed. They may even embrace the features that make their face unique.

But sometimes, eye asymmetry isn’t just an aesthetic issue. It can be caused by an eye or health problem that may require medical treatment. Possible causes of uneven eyes include:

Bell’s palsy – A temporary paralysis of the facial nerve, Bell’s palsy can cause one side of the face to droop. The condition can make it difficult to close the affected eye or move the eyebrow on one side of the face, causing the appearance of eye asymmetry. Bell’s palsy is not life-threatening and most people (about 85%) recover fully within a few months.
Stroke – Though it can present with facial paralysis symptoms similar to Bell’s palsy, a stroke is a medical emergency. If you have symptoms of a stroke, including sudden vision loss, call 911.
Blepharochalasis – Swollen eyelids (blepharochalasis) may be caused by allergies, infections or injuries. This condition can occur on the upper or lower eyelid and can happen in both eyes (bilateral) or just one eye (unilateral), causing the appearance of asymmetry.
Enophthalmos – A sunken eye (enophthalmos) may be caused by getting hit in the eye, having a car accident or sustaining other trauma to the eye. It may also be caused by cancer, HIV or problems with the sinuses. One sunken eye can result in a look of unevenness between the two eyes.
Heterochromia – In some cases, heterochromia is a hereditary condition that causes a person to be born with two different-colored eyes. It may also be caused by an underlying illness or injury. Heterochromia is a rare condition, affecting about one in every 1,600 people.
Ptosis – A condition that causes droopy eyelids, ptosis can occur in just one eye (unilateral ptosis), causing the eyes to look different from each other. It can also occur in both eyes (bilateral ptosis). Ptosis may be caused by aging, a nerve or muscle problem, or a growth on the eye.
Exophthalmos – Bulging eyes (exophthalmos) are most commonly caused by hyperthyroidism and Graves’ disease, both of which are linked to thyroid eye disease (TED). Injuries, cancers, infections and tumors can also lead to bulging eyes. If one eye appears bigger than the other, the eyes may look asymmetrical.

An eye doctor can diagnose and treat eye conditions that cause periocular asymmetry (lack of symmetry around the eyeballs). In some cases, these treatments can give the eyes a more symmetrical appearance.

How to fix asymmetrical eyes

If you’ve noticed a drastic difference or sudden change in your eye symmetry, schedule an appointment with your eye doctor right away. But if you’ve always had an eye that looks a little different from the other, you may be seeking tips on how to cosmetically fix asymmetrical eyes.

Uneven eyes are unique to every person, so there’s no one-size-fits-all solution. Here are four ways to address the uneven look of asymmetrical eyes:

Makeup for asymmetrical eyes – You can use makeup techniques to create the illusion of eye symmetry. Eye makeup for uneven eyes may be able to make an eye look bigger or smaller, or higher or lower.
Botox for asymmetric eyes – Depending on the issue, an eye doctor may be able to use injections of Botox around the eye to fix uneven eyes. Botulinum toxin may also be an option for correcting asymmetrical brows that give the eyes an uneven look.
Surgeryfor asymmetrical eyes – In some cases, surgery may be a good option to correct or minimize eye asymmetry. The type of surgery will depend on the specific eye issue. For example: An eyelid lift (blepharoplasty) may be done on the upper or lower eyelid to correct the effects of ptosis. Surgery may also be used to treat a sunken eye.
Topical eye drops for droopy eyelids – Ask your doctor about Upneeq, a topical eye drop that is FDA-approved for treating asymmetrical eyelid position resulting from acquired ptosis.

Are you hoping a special eye exercise will correct your uneven eyes? While there are numerous exercise techniques that claim to fix asymmetrical eyes, there’s a lack of evidence that these eye exercises work.

Makeup techniques for uneven eyes

Specialized makeup techniques can help make uneven eyes look more symmetrical. You can use makeup to make a smaller eye look bigger or make a lower eye look higher on the face.

Makeup artist Sharon Farrell has a sunken eye due to sinus issues, which causes her eyes to appear uneven. She shares the following tips for getting a more symmetrical look:

If you have a sunken eye, use dark eyeshadow in the crease of your non-sunken eye to create a more pronounced crease to match the other eye. Blend the dark shadow using a tapered eyeshadow brush.
Next, add (less) eyeshadow to the crease of your sunken eye, but use a lighter touch to account for the more pronounced natural crease. This will make the eyes look more even.
Line both lower lids with a medium shade of the eyeshadow used in the creases, drawing it outward to the corners and upward to connect it to the crease of each eye.
Choose a darker medium shade of eyeshadow for your eyelids and blend well. Avoid a lighter shade as it will draw attention to the differing amounts of space on each eyelid.
Go back with a very dark shade of the same color eyeshadow, using a very small brush to define the crease on the non-sunken eye even more. Blend a little of this darker color in a triangle shape along the outside corner of your eye.
Use a fluffy brush to add the same very dark shadow to the outside corner of the sunken eye so the eyes match. But don’t define the crease on the sunken eye.
Apply eyeliner to the upper lids of both eyes. You can apply a “wing” of eyeliner and blend it for a smoky look.

Celebrities with asymmetrical eyes

There are many celebrities with uneven or asymmetrical eyes. Here are some of the most notable:

Paris Hilton – Paris Hilton grew up with the nickname “Star” and has been stealing the spotlight ever since. The actress and heiress got her start on the reality show The Simple Life and quickly skyrocketed to fame. Hilton has asymmetrical eyes due to amblyopia (lazy eye) in her left eye. This disorder usually occurs in one eye and can affect vision.
Kat Graham –The Vampire Diaries actress has facial asymmetry in which her left eye sits noticeably higher than her right eye. Many fans think this asymmetry is a big part of her unique look. Graham tends to take photos with her head tilted to one side, which makes the asymmetry less obvious.
Mila Kunis – The actress who got her start on That 70s Show and starred in movies such as Black Swan and Bad Moms has two different-colored eyes due to iritis. A chronic inflammation of the iris, iritis affected Kunis’ vision in one eye before she had surgery to replace the lens. Her left eye is green and her right eye is hazel.
Shannen Doherty – The actress who got famous for her role in Beverly Hills, 90210 has an asymmetrical face and eyes. In fact, Doherty’s left eye sits noticeably higher than her right eye.
Thom Yorke – The Radiohead singer was born with his left eye closed due to a lack of eye muscles. He later had surgery to correct eye drooping on that side, but his left eye still looks different from his right. Yorke has stated in an interview that he now likes that he looks “different.”

Some celebrities have sought out “asymmetrical eye surgery” from a cosmetic surgeon to try to make their eyes look more even. Plenty of others, though, have embraced their uneven eyes as part of their unique look.

See your eye doctor for uneven eyes

It’s important to get regular eye exams for good eye health. While slightly asymmetrical eyes are common, uneven eyes can be a sign of an underlying eye or medical condition.

If you have asymmetrical eyes, your eye doctor can perform an eye exam to help determine the cause and outline your treatment options.

Notes and References

Eye asymmetry. Taban MD Oculoplastic Surgery. Accessed February 2022.

Stroke symptoms. American Stroke Association. Accessed February 2022.

First prescription fix for droopy eyelid. American Academy of Ophthalmology. September 2020.

Mila Kunis. Biography. March 2022.

Shannen Doherty. IMDB. Accessed February 2022.

Page published on Wednesday, March 2, 2022

Medically reviewed on Monday, January 17, 2022

Anisocoria

Anisocoria is unequal pupil size. The pupil is the black part in the center of the eye. It gets larger in dim light and smaller in bright light.

The pupils of an individual are usually very symmetrical in appearance. In certain instances the pupils may vary in size. Occasionally, differing pupil size is inherited and there is no underlying disorder. Varying pupil size may also be due to infection, tumors, disease or trauma.

Considerations

Slight differences in pupil sizes are found in up to 1 in 5 healthy people. Most often, the diameter difference is less than 0.5 mm, but it can be up to 1 mm. Babies born with different sized pupils may not have any underlying disorder. If other family members also have similar pupils, then the pupil size difference could be genetic and is nothing to worry about. Also, for unknown reasons, pupils may temporarily differ in size. If there are no other symptoms and if the pupils return to normal, then it is nothing to worry about. Unequal pupil sizes of more than 1 mm that develop later in life and do not return to equal size may be a sign of an eye, brain, blood vessel, or nerve disease.

Causes

Aneurysm in the brain
Bleeding inside the skull caused by head injury
Brain tumor or abscess (such as pontine lesions)
Excess pressure in one eye caused by glaucoma
Increased intracranial pressure, because of brain swelling, intracranial hemorrhage, acute stroke, or intracranial tumor
Infection of membranes around the brain (meningitis or encephalitis)
Migraine headache
Seizure (pupil size difference may remain long after seizure is over)
Tumor, mass, or lymph node in the upper chest or lymph node causing pressure on a nerve may cause decreased sweating, a small pupil, or drooping eyelid all on the affected side (Horner syndrome)
Stroke
Injury to the carotid or vertebral artery
Diabetic oculomotor nerve palsy
Prior eye trauma, including surgery for cataracts

Home Care

Treatment depends on the cause of the unequal pupil size. You should see a health care provider if you have sudden changes that result in unequal pupil size.

When to Contact a Medical Professional

Contact a provider if you have persistent, unexplained, or sudden changes in pupil size. If there is any recent change in pupil size, it may be a sign of a very serious condition.

If you have differing pupil size after an eye or head injury, get medical help immediately.

Always seek immediate medical attention if differing pupil size occurs along with:

Blurred vision
Double vision
Droopy eyelid
Eye sensitivity to light
Fever
Headache
Loss of vision
Nausea or vomiting
Eye pain
Stiff neck

What to Expect at Your Office Visit

Your provider will perform a physical exam and ask questions about your symptoms and medical history, including:

Is this new for you or have your pupils ever been different sizes before? When did it start?
Do you have other vision problems such as blurred vision, double vision, or light sensitivity?
Do you have any loss of vision?
Do you have eye pain?
Do you have other symptoms such as headache, nausea, vomiting, fever, or stiff neck?

Tests that may be done include:

Blood tests such as CBC and blood differential
Cerebrospinal fluid studies (lumbar puncture)
CT scan of the head
Electroencephalogram (EEG)
Head MRI scan
Tonometry (if glaucoma is suspected)
X-rays of the neck

Treatment depends on the cause of the problem.

References

Balcer JL. Pupillary disorders. In: Liu GT, Volpe NJ, Galetta SL, eds. Liu, Volpe, and Galetta’s Neuro-Ophthalmology. 3rd ed. Philadelphia, PA: Elsevier; 2019:chap 13.

Nischal KK. Ophthalmology. In: Zitelli BJ, McIntire SC, Nowalk AJ, Garrison J, eds. Zitelli and Davis’ Atlas of Pediatric Physical Diagnosis. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 20.

Thurtell MJ, Rucker JC. Pupillary and eyelid abnormalities. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff’s Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 17.

Version Info

Last reviewed on: 4/29/2023

Reviewed by: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School of Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.