Eyes that are sunken in, or enophthalmos, can happen after fractures in your face or as a result of other changes in your eye socket or your eyes themselves. Treatment and prognosis depend on the cause.
Enophthalmos is the term for when your eyes are sunken in. The “en” refers to “in” and “ophthalmos” means eye. The opposite of enophthalmos is exophthalmos (proptosis) of the eyes, also called bulging eyes.
Sunken eyes, or enophthalmos, can be something that you’re born with (congenital), or something that happens to you sometime after birth (acquired). It can happen in one eye (unilateral) or both eyes (bilateral).
There are several reasons why enophthalmos happens. These include dehydration, diseases like Horner’s syndrome and traumatic eye injuries, like those that might occur during motor vehicle or other accidents or during physical fighting (traumatic enophthalmos). Congenital conditions such as silent sinus syndrome can cause enophthalmos. Getting older may also cause enophthalmos (senile enophthalmos).
Enophthalmos often happens after accidents involving cars, trucks and motorcycles, or after physical fights that result in orbital fractures. These fractures are breaks in the bones that surround the eyes. The condition happens more often in men and people assigned male at birth.
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Signs and symptoms of enophthalmos depend on what caused the condition. They may include:
A healthcare provider may be able to see some of the signs — sagging eyelids, facial asymmetry and misalignment of your eyeballs — just by looking at you.
You can have sunken eyes because of many things. The causes generally fall into a few categories.
People use the word “orbit” to refer to the actual cage made of bone around your eye. It can also refer to the cage and the contents of the cavity together. If the size of your socket (orbit) changes and becomes bigger, the contents (including your eyeball) can shift position. Your orbit might change in size for a variety of reasons, including:
Your eyes can sink because of changes in the contents of your eye socket. These may include:
Sometimes, changes to your eye itself can change its position. These changes include:
In many cases, a healthcare provider can see that you have enophthalmos by looking at you, especially when enophthalmos affects one eye. In addition to taking a medical history, your provider will do an eye examination.
There are also tools and tests that eye care specialists can use to measure whether or not you have enophthalmos, including:
Treating enophthalmos involves treating the underlying condition. This could mean:
Treating enophthalmos may result in complications, including:
One way you can reduce your risk of developing this condition is by lowering your risk of fractures of bones in your eyes and face. Use protective equipment when you should. Drive carefully. Avoid fistfights.
Much of the outlook for someone with enophthalmos depends on the cause of the condition. For instance, people who are younger who are treated for fractures or silent sinus syndrome usually have a very good outcome.
If you have any type of accident involving blows to your eyes or face, be sure to see a healthcare provider. It’s also important to see your provider if you develop any type of vision issues, including blurred vision or double vision.
Enophthalmos refers to your eyes sinking deeper in your eye socket. Hypoglobus is a downward displacement of your eyeball. Potential causes of either include trauma and silent sinus syndrome.
Anophthalmos means that you’re missing one or both eyes. Enophthalmos means that your eye has shifted position.
There are conditions that may look like the globe of your eye has been displaced. In some cases, if one eye is more nearsighted (has more myopia) than the other, it may look like one eye has enophthalmos.
A note from Cleveland Clinic
If you have sunken eyes (enophthalmos), your healthcare provider will work with you to find out what’s causing it. This condition may happen because of something obvious, like fractured bones, or because of something that you don’t even realize is happening, like sinus issues. It’s important to see your healthcare provider if you’ve had an accident that results in injury to your face or eyes. And it’s always important to talk to your provider if you notice any type of change in your vision.
Last reviewed by a Cleveland Clinic medical professional on 11/02/2022.
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