What causes sunken eyes?

Orbital hollowing may be caused by physiological and pathological factors, as analyzed below:

I. Physiological Factors

Orbital hollowing may be related to individual differences. On one hand, some people are born with naturally sunken orbits, which may result from their unique skeletal structure. On the other hand, aging and overall health conditions can also contribute to the development of orbital hollowing. For congenital or physiologically caused orbital hollowing, corrective measures such as orbital augmentation, orbicularis muscle enhancement, or hyaluronic acid injections can be used to improve the hollow appearance.

II. Pathological Factors

1. Atrophy of orbital fat tissue
Atrophy of the orbital fat tissue can also lead to orbital hollowing. The orbital fat has a rich neurovascular supply system containing both blood vessels and nerves; prolonged insufficient blood flow may result in tissue degeneration and loss. For orbital hollowing caused by fat atrophy, fat grafting or fat filling procedures may be considered. These methods involve transplanting or injecting the patient’s own fat tissue into the orbit to fill the hollow areas and restore volume.

2. Orbital fracture
Orbital fracture is a common cause of orbital hollowing. A fracture can reduce the orbital volume and create an abnormally deep-set appearance. This may further impair normal ophthalmic functions, including vision, eye movement, interocular distance, and facial aesthetics. Orbital hollowing resulting from fractures typically requires surgical correction. Surgical options include open surgery or minimally invasive subcutaneous endoscopic repair techniques to restore the orbital contour and improve appearance.

In general, treatment for orbital hollowing should be tailored according to the specific underlying cause. Treatment plans must take into full consideration the patient's individual circumstances, including medical history, overall health, and severity of the condition, to determine the most appropriate approach. Additionally, postoperative care is essential, including maintaining personal hygiene, preventing infection, and avoiding wound dehiscence or tearing.