@CoHDa - Some of your symptoms sound like those for ICA compression. When you noted the disparity in your eyes, I immediately wondered if you might have Horner’s Syndrome though your description made it unclear if your left eyeball itself is enlarged or if it’s your pupil. I think w/ Horner’s it’s a difference in pupil size along w/ other symptoms, but it’s a very one-sided issue & is linked to ICA compression.
Here’s info that @KoolDude posted for one of our members that might be helpful for you. This post is on Day 16 of a pretty long thread so if you don’t want to read the entire thing, you can jump to that point.
Left Internal Carotid Artery (ICA) and Styloid Contact : I have found that your elongated Styloid is rubbing against your ICA and could potentially be compressing/irritating it when you look down. Typically, Carotid compression/irritation mainly manifests as (Syncope, presyncope, vision changes, dimmed vision, slurred speech, difficulty speaking, lower cranial nerve dysfunction. Horner’s syndrome, ptosis (drooping eyelid), constriction of the pupil, loss of sweating over the ipsilateral face, upper/lower extremity paresthesia. Weakness or paralysis of face, arm or leg, dizziness, unsteadiness, or falls.). So this needs to be investigated with dynamic angiogram specially in flexion position (bending the neck down) to see if it is compressing it. I am not a doctor, but based on literature, it could potentially cause stroke as well so this needs an urgent addressing.
Link for the full thread: Buzz. My case history, findings and radiology images - #47 by KoolDude
Dr. Samji did my ES surgeries. I thought he was great but some of our members who’ve seen him more recently haven’t had as good outcomes. I’m not sure if he’s changed how he’s doing surgery or if my case was less complicated. Obviously Dr. Cognetti is in Philly, & he would be another good option for you. He will do your initial consult via phone or video call which would save you having to travel.