The cause of uneven eyelids is due to three factors. It is important to differentiate the cause of uneven eyelids as the cause will dictate how it will be corrected.
The first cause is due to uneven double eyelid fold height. Some patients are born with uneven double eyelid fold height. But some patients develop uneven double eyelid fold height by developing a higher double eyelid fold. Or the patient can lose the original double eyelid fold height and the double eyelid fold height can get lower over time.
The second cause is irregular excess skin hooding from aging. As people age, skin hoods and one part of the eye can hood more than the other. This will lead to uneven eyelid shape and double eyelid fold height.
The third cause of uneven eyelids is due to unilateral eyelid ptosis. Eyelid ptosis is when there is a weakness of the eyelid elevating muscle–levator aponeurosis muscle. When there is a weakness of the eyelid levator muscle, the affected eye will appear smaller. However, the double eyelid fold will appear larger on the side with the eyelid ptosis (weak eyelid muscle function).
In the next blog, we will discuss how to treat these uneven eyelids.