Eye sunken deeper & lower into socket, is this correctable? (Photos)

Question

My eye has sunken deeper and lower into socket over the past month. Ophthalmologist has checked my eyes says he doesn’t know what the issue is. When I look at people with the same symptoms silent sinus syndrome or enophthalmos seem to be what it is but I have no idea what to do next. I have an appointment with my Dr tomorrow and will ask for a ct scan but he says it is from Botox and it is not. He said my eye sunk from Botox at the last appointment. I need to know where to ask him to refer to

John Michael Thomassen, MD · Answer

Did you have trauma to the affected eye?  This is the most common cause of enophthalmos due to an orbital fracture that changed the volume of the orbital socket.  If not, any reason you may be loosing fat volume around the globe?  The correction may involve placing a graft in the socket to help lift the globe further out.  However, this may create more asymmetry.  Considering your photos, I do not believe you have enough asymmetry to warrant such a procedure.

Kenneth D. Steinsapir, MD · Answer

You don't need a CT scan for this. You have upper eyelid ptosis with a central levator disinsertion and a compensatory eyebrow elevation. The upper eyelid sulcus appears hollow due to retraction of anterior orbital fat, also called the preaponeurotic fat, into the orbit with the the retracting levator aponeurosis. The upper eyelid fold volume is contributed by the preaponeurotic fat and also a small amount of fat that is contributed by the retroorbicularis oculi fat pad. That fat pad gets lifted up by the compensatory elevation of the eyebrow. Muellerectomy (Mueller's muscle conjunctival resection ptosis surgery) is immensely popular with eyelid surgeons. However, this surgery will not be right for you. Your central levator aponeurosis is not attached to the upper eyelid tarsus. The Muellerectomy will not be sufficiently effective to encourage the eyebrow to relax down. For these reasons, I usually recommend the anterior levator resection ptosis surgery. There is no substitute for a detailed in person assessment. Your eyes can be your best feature.

Ayse Dolar Bilge, MD · Answer

Upper eyelid filler exactly improves your problem.Its an office procedure.Best regardsDr Ayse Dolar Bilge

Eye sunken deeper & lower into socket, is this correctable? (Photos)

Answers (3)

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