Droopy Eye Lid - Please can anyone assist me to understand?

[bhissett]

I need your opinion. Spring of 2007 I noticed my eyelids were not symmetrical, my right eye had changed. That fall I noticed that my right eye was lower than my left, this was not right. I went to see my optometrist and he referred me to an eye surgeon. Fall of 2007 he had me take a CAT scan. The hospital staff saw nothing unusual. The eye surgeon pointed out that my right sinus was narrower. It had collapsed that is what had caused my right eye to sit lower on my face. He told me that I should wait atleast a year to have another CAT scan to see if it was still changing. I finally had the second CAT scan done this May. There was no change. The eye surgeon suggested that he would like to perform eye surgery on the left eyelid to make the eyes more symmetrical. I didn’t like his answer, my right eye would still be lower and I want to know why did my right sinus collapse. I then got my family doctor to refer me to a sinus, nose and ear specialist, I saw him last week. He did not look at the CAT scans, just read the hospital report where it stated there was nothing unusual. The specialist did see the difference in my eyes symmetry, but commented that possibly my right sinus has always been narrower than the left. He is referring me to a sinus specialist (a Rhinology Endoscopic Skull Base Surgery – Otolarynogoly) in another province, I am waiting to hear from them when my appointment will be.
Can you please help me out to what you think might have happened to my eye and what I should be doing. I am a 49 year old healthy female. I don't want to waste anymore time and don't like the way I look now. Please help me!!!!

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[physiobob]

Sounds to me like unless you had an injury to the area that this was always the case from birth? There are bone diseases that cause growing of the skull and bones abnormally (Paget's disease) but this would have more signs in other areas. Also this is normally an enlarging of the skull. Unfortunately Physio won't move an eye socket that is at a different height to the other side. You should be clear though on whether the eye itself is different (with a level head) or wdether the different in tone of your eyelids are causing the appearance of one eye being lower than the other. This is as there are several reasons for droopy eyelids or ptosis. See more on that here Ptosis

[bhissett]

Thank you physibob for replying to my question. I was never injured in the face and my eyes were symmetrical until 2007. I have been doing some research on line and I am thinking it may be the silent sinus syndrome that I have. Do you think I am correct? If so, what are my options?

Bev

[physiobob]

Maybe you can get someone to take a photo of your face and post it to the forum so we can make more of a comment on what we see.

[bhissett]

Thank you physiobob,
I will post some before and after pictures this evening.
Bev

[bhissett]

Please find attachments of pictures I have taken in the past to show the difference in my eyes symmetry. The file name is the year in which the pictures were taken. Hopefully this will help to receive feedback to what may have happened. As stated in my first thread, I began to see a difference in my right eye spring of 2007.
Thank you, Bev

[Dr Damien]

Dear Bhissett

From your posts, one can tell that this current problem worries you. I would agree with physiobob on his suggestions. While there might be no connection, I could not help but notice you had a fracture previously.
Is there anyone in your family with this problem? (the current one i mean-sinking right eye). Have you had issues with the sinus in the past?
Unfortunately, this field is beyond the scope of physiotherapy, however like physiobob has suggested undestanding the state of your bones generally might give a better insight as to why this has happened...

The good thing is, from your description, it does not seem to be getting worse...it feels like a gradual change in skull pressure with weakned bones made this happen...
Did you have a bad case of an infection during that period-2007? You did say you are a healthy female, during that period when you first notice this issue, did you have sinus issues...

It is good to rule out a neurologic disposition however i doubt if this is the case with you...

I feel that some surgical intervention may be the answer...however it is good to have the understanding of your bones first of all...i presume this would have been picked up in your previous radiographs if this was an issue...

[bhissett]

Hi Dr Damien,

What do mean "could not help but notice I had a fracture previously"? I have never had a fracture. I did have lasik eye surgery done June 2005 and then again that fall.
There is no one in my family that I know of with this problem. I don't believe I have ever had any sinus issues, even when I noticed the change in my eyes.

I did have an eye infection winter of 2006/07. My optomitist gave me some drops which I ended up getting worse. He told me I had an allergic reaction to the drops and gave me another presciption which cleared up the infection. The only problem I seem to be having with my eyes is they both seem to feel gummy a lot of the time, my vision doesn't seem to be as clear as it should be. My optomitist said that he figured a duct in my eyes was not working well (I cannot remember which duct he named) he suggested I take Omega III to help. I have not seen any improvement. I have a picture that was taken when I had the infection, would it help if you saw it?

I asked my family physician to refer me to a sinus specialist (I wanted a second opinion - other than the eye surgeon who wanted me to reshape the eyelid of the left eye) which I saw last month he has referred me to see DR. Brad Mechor MD FRCSC Rhinology Enoscopic Skull Base Surgery (Otolaryngology) at the Calgary Sinus Centre in Calgary, Alberta mid December. Dr. Mechor has a copy of my CAT scan taken in June as well has set up an appointment the same day I see him for another CAT scan.

Have I done all I can to seek help, or is there anything else I should be checking out?

Thank you,
Bev

[Dr Damien]

Dear Bhissett,

My apologies for assuming that you had a fracture, i was reading your previous posts and I believe it was titled "misdiagnosed ankle fracture"...I presumed that was you and you had been diagnosed with a previous fracture in your leg...

If that was you, my thoughts were perhaps there might be some weakened bone issues, this is a far fetched theory, but its often good to look at all aspects of someones history to see relationships....especially with this case that seems unresolved and puzzling. If you never had a fracture as suggested by that post, again I apologize for my assumptions.

yes, please post the picture of when you had an infection in the eye. was this the same eye that now feels like its dropping?

...In my own opinion, I think you are doing probably the best you can do for yourself at the moment...anatomic changes like these really suggest surgical correction may be the answer, again its best to have the opinion of a maxillofacial specialist which you are already doing...

I myself have issues with some assymetry of the face, I started to notice this as I approached my late teens and early twenties...I have serious sinus issues and it runs in the family. I have had previous xrays and some sinuses on certain aspects of my face are more or less obliterated. So i have some understanding how this might make one feel.

My believe is there was an ongoing assymptomatic problem that resulted into this...checking thoroughly your history will give some light at least in understanding what went wrong...

I think all these issues that seem trivial to you...I.e eye infection, blocked ducts....might be related to this new problem...again i stand with physiobob to consider looking at the density of your bones...

Cheers

[bhissett]

Thank you Dr Damien,

Yes, that was an old posts of mine that you found when I broke my ankle and foot November 2008. I have had no problems with these breaks since they healed a few months later.
I thought you were talking about a fracture to my face!!!!

It never occurred to me that there might be a relationship between my fractured foot/ankle to my unsymmetrical eyes.

I attached a picture of me when I had the infected eyes back in January 2007. If I remember correctly I thought both eyes were infected, but it does appear to be worse in the eye that I am concerned about now.

When I go to see the specialist next month and it turns out that I do have a problem with my bones density, is there anything that can be done to correct my right eyes level?

Thank you so very much for understanding me and for your helpful advice.

Take care.