A large and small eye at an older age may be influenced by physiological factors.
Patients may have drooping eyelids due to loss of elasticity of the skin as a result of ageing. When the magnitude of bilateral eyelid ptosis is different, this may lead to the development of large and small eye symptoms.
There are also some patients who have increased bags under their eyes due to ageing, which can also cause a person to develop the appearance of different eye sizes.