My right eye is protruding more than my left eye

I have seen other posts here from people with the same issue.  I know we all have slight differences in our eyes including me.  However, this started about 4 months ago where my right eye was prominently larger than my left - people started asking what is wrong with your eyes.  

I feel that my right eye is definitely sticking out more than my left, but it seems to me that my left is also smaller than in previous years.  When looking at photos, the smaller eye (left) feels to me to be the one that has changed.
Can someone's eye go inwards?

I have an annual eye exam and my eye sight is the same as last year with my right more near sighted than my left.  I went to see an Opthalmologist and she did all the tests and ruled out Graves disease etc as there is no pressure or inflammation.  Thyroid is normal and has been for several years. I just did the MRI with contrast and am waiting on the results.  If it is also normal - which I suspect it will be.  I don't have any paralysis on my face, no headaches or pain.  What doctor should I see next and what tests should I get?

Please help as this is really depressing me.

[Christopher C Shen, MD]

The most common cause of proptosis (protruding of the eyes) is thyroid disease although sometimes the thyroid testing can be normal so assuming what the MRI shows, if there are any anatomical abnormalities, it should be obvious.  Scenarios where the eye is sunken back (enophthalmos) are much less common and usually related to previous eye trauma with instability of the orbital floor and rarely secondary to breast cancer metastases.  If the imaging comes back normal, I would consider a second opinion from an oculoplastics specialist if one is available in your area.  One other thing to rule out is if your upper eyelid is simply drooping downward (ptosis), creating the appearance of the nonaffected eye appearing to be bulging out.  

[tarahsu]

Thanks Dr. Shen
The MRI came back normal.  I have scheduled an appt next week with a Neuro-Opthalmologist and my Opthlamologist recommended I call an Ocularplastics specialist so will make that appointment as well.  Can the Ocularplastics specialist determine whether the upper eyelid is drooping on the smaller eye or do I need to see a plastic surgeon too?

[Christopher C Shen, MD]

The oculoplastics surgeon will definitely be able to determine lid position much better than a regular plastics guy through a series of diagnostic testing and better understanding of lid anatomy.