This patient also had contact lens induced left ptosis (droopy eyelid, top picture). Correction of the left ptosis resulted in droopy of the right ptosis which alarmed the patient (middle picture taken at one week after posterior approach ptosis correction). Two main factors may be responsible for this phenomenon: a. The patient had ptosis in both eyes with one eye being more severely affected. Therefore, successful correction of one eye will bring out the contralateral ptosis. b. The ptotic eye was overcorrected resulting in the opposite eye becoming droopy. However, most oculoplastic surgeons usually overcorrect droopy eyelid slightly so that any drop of the eyelid during recovery will be compensated.
As this patient did not have right ptosis before the operation, the most likely cause for the imbalance is factor b and she was reassured. At 6 weeks follow-up the two eyes were nearly symmetrical (bottom picture).