How is enophthalmos of both eyes corrected?

Question

My eyes are recessed and sunken in the orbit sockets, the left eye is worse than the right. They look strange, how can this be corrected so they are more prominemt "normal?"

Douglas L. Vander Woude, MD · Answer

Enophthalmos can be corrected, in some situations.  Most often that is after trauma that resulted in an increase in the volume of the orbit (the space that the eye occupies).  If it is a change that is age related, there may be other options.  An exam by a surgeon with experience in these matters would be essential.  Thanks for your question.

Mehryar (Ray) Taban, MD, FACS · Answer

It is difficult to actually make the eyes less bulging. It is easier to fill around the eyes if there is sunken areas around the eyes. See an oculoplastic specialist for evaluation. See following link and video for two different approaches.

Benjamin Caughlin, MD, FACS · Answer

This is tough to answer without seeing you for an exam. As we age we lose bone, fat and skin elasticity. There are studies with X rays of the skull of people over their liftime that show the orbit cavity widens overtime due to this bone loss. So this then allows the eyeball itself to fall into the orbit deeper. As this happens the orbital fat is pushed out of the eye socket. So, we as surgeons have developed ways to treat this. Most of this is accomplished by camouflage techniques. My favorite of which is fat transfer. We take fat from the belly or thigh and use it to smooth this transition from the eye subunit to the cheek subunit.   Below are other causes and treatments that help with this issue. The best option is to see someone for a good exam and hear options that are tailored specifically to you. 1. Prolapsed orbital fat through the orbital septum: treated with lower lid blepharoplasty and fat re-positioning. Can also be helped with fillers or auto fat transfer to the face but the ideal treatment in my hands is surgery for this issue.

2. Eczema: much more common in young people with fair skin. The treatment for this is to hold off on makeup and any manipulation of the lower lid for a few weeks and try some topical anti inflammatory creams. If you have allergies those should be treated also.  A dermatologist is the best person to see for this. We have a multidisciplinary clinic with myself, a plastic surgeon, and my partner, a dermatologist which I think is ideal!

3. Fluid accumulation and/or redundant skin. Could be possible in young patients but would need a good facial analysis and exam to determine. A low salt diet (< 1000mg/day) and a warm compress can help.  I would consider treating with filler/fat transfer, lower lid fractional ablative laser and/or lower lid blepharoplasty.

4. Descent of midface cheek pad. This then causes the nasojugular ligament to become more prominent creating a demarcation and separation of the eye from the cheek subunit. Treated with mid face lift and fat transfer.

It is all about the balance of this transition from the orbit to the cheek. There are many ways to treat this and they vary by the underlying cause. I recommend seeing a surgeon who also does a lot of these treatments. This can make a big difference as most people have a combination of the above that lead to the issue.

Hope this helps.

Best of luck,

DrC

John McCann, MD, PhD · Answer

Hi BBLdoll2015,

Thanks for your question. A sunken, recessed appearance to your eyes can have a few different causes. It would be hard to comment on what the cause is and how to correct it without a photo illustrating your concerns.

Please post a pic and we would be happy to comment or make some recommendations. Thanks!

How is enophthalmos of both eyes corrected?

Answers (4)

Answer: Enophthalmos

Answer: Enophthalmos

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How is enophthalmos of both eyes corrected?

Answers (4)

Answer: Enophthalmos

Answer: Enophthalmos

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