Sunken Eyes: Causes, Symptoms, Home Remedies & More 

Introduction

Sunken eyes is a condition in which the eye socket looks sunken. It may occur due to enophthalmos, a condition in which the eyeball moves posteriorly, giving the appearance of a sunken eye¹ or common causes like lack of sleep, dehydration², ageing³, stress, poor nutrition, and sudden weight reduction. Sunken eyes may make a person look tired, dull, or older than their age and may impact their self-confidence. 

Sunken eyes may also indicate underlying health conditions, such as sinus problems, chronic allergies, tumours, or injuries¹. Therefore, understanding the causes of sunken eyes, their management options, and protective measures is important for better management. 

What Is a Sunken Eye?

Sunken eyes meaning is that the eyeballs appear to move backward into the eye socket more than normal. Eyes may also look sunken or hollow due to conditions like dehydration when the tissue surrounding the eyes loses elasticity. This may cause the upper eyelid area or the bone underneath the eyes to look more prominent. 

Sunken eyes are commonly caused by loss of the fat around the eyes, a fracture of the eye socket, and tightening of the tissues around the eyes, which pulls the eyeball backward¹. Let’s look at the causes of sunken eyes in detail. 

Causes of Sunken Eyes

Reasons for sunken eyes include the following: 

1. Ageing and Loss of Facial Fat

Ageing can cause the fat around the eyelids to move deep into the eye socket, making the eyes look more sunken⁴. Loss of body fat, including facial fat, can also contribute to sunken eyes³.

2. Lifestyle

An unhealthy lifestyle may lead to sunken eyes. Lifestyle factors associated with sunken eyes may include: 

• Poor sleep: Inadequate or poor quality of sleep may cause dark circles and wrinkles under the eyes⁵. These wrinkles may make the eyes look deeper or sunken. 
• Weight loss: Severe or sudden weight reduction can cause fat loss from the body, including around the eyes, making them look hollow or sunken¹. 
• Smoking: Smoking may cause reduced blood flow to the skin¹ and damage of the collagen, contributing to sunken eyes. 
• Stress: Chronic stress may cause reduction in skin elasticity and firmness under the eyes along with dark circles⁶, which may make the eyes appear more sunken. 

3. Underlying Health Conditions 

Sunken eye causes can sometimes include certain underlying conditions such as: 

• Dehydration:^2,7 Inadequate fluid intake or dehydration due to conditions like diarrhoea may make the skin under the eyes dry, lose elasticity, and appear hollow and sunken. 
• Malnutrition: Poor nutrition may cause loss of fat around the eyes, making them look more hollow or sunken¹.
• Sinusitis or allergies: A long-term sinus problem in the cheeks or allergies can cause the bottom of the eye socket to sink in. This can make the eye look sunken. 
• Eye injury (orbital trauma): After an injury, scarring may cause tissues inside the eye socket to shrink or the thin bones of the eye socket to become fractured, resulting in the appearance of a sunken eye. 
• Cancer: Cancer that spreads to the eye socket can sometimes cause the eye to look sunken as a result of mass affecting the bone or may be due to surgical loss of tissues following cancer surgery or following post-cancer radiation therapy. This may especially be seen in certain types of breast cancer that spread to the orbit¹.
• Sagging brain syndrome: Long-term low brain fluid pressure from sagging brain syndrome may cause the eyeballs to move backward, resulting in sunken eyes⁸.
• Gastrointestinal problems: Gastrointestinal issues like diarrhoea cause dehydration and malabsorption of nutrients, which may contribute to sunken eyes⁹.
• Surgery: Surgeries like V-P shunt can rarely contribute to low brain fluid pressure. This may cause sunken eyes, especially if there is a weakness or defect in the eye socket wall^8,10.

Symptoms Associated With Sunken Eyes

Symptoms you may observe along with sunken eyes include: 

• Hollow Look: The under-eye area may have a noticeable dip or sunkenness, making the eyes look deeper. 
• Thin Skin: The skin under the eyes may look very thin or delicate¹.
• Loose Skin: The under-eye skin may look slightly saggy. 
• Prominent Eye Sockets: The eyes may be set deeper in the socket, making them more visible (mostly age-related)¹¹.
• Dark Shadows: The hollow under the eyes may create shadows, which make dark circles seem more prominent¹².
• Visible Fine Lines: Thin or dry under-eye skin may result in visible small wrinkles under the eyes. 

Diagnosis of Sunken Eyes

Sunken eyes may be diagnosed as follows: 

• Physical Examination: 
  • The doctor may first check your vision, then examine the pupils, and measure eye pressure. 
  • They may also examine the face, eye position, eyelids, eye movements, and the area around the eyes¹.
• Medical History Review: The doctor may ask questions about your weight, sleep patterns, diet and nutrition, fluid intake, allergies, smoking habits, gastric issues, and any ongoing conditions or medications. 
• Blood Tests: Blood tests may be recommended to check for suspected nutritional deficiencies or systemic illnesses like anaemia, vitamin deficiencies, thyroid function, and cancer. 
• Imaging Tests: In rare cases, scans like CT or MRI may be done if the doctor suspects problems in the eye socket or surrounding structures. 

Management Options for Sunken Eyes

Various approaches may be used to manage sunken eyes depending on their cause. Sunken eyes treatment methods include: 

1. Medical and Cosmetic Options

These include: 

• Dermal filler injections with hyaluronic acid: May help restore lost volume of under-eye tissue and reduce hollowness. 
• Fat grafting using fat from another body part: May help restore under-eye volume¹.
• Platelet-rich plasma (PRP) therapy using patient’s blood components: May help improve skin texture and collagen. 
• Laser therapy: May help improve skin quality and reduce under-eye shadows. 
• Chemical peel: May improve skin texture and reduce discoloration¹³.

2. Management of Underlying Conditions 

If you have any underlying conditions that have caused sunken eyes, managing them may help improve sunken eyes. Such conditions and potential management options include: 

• Sinusitis or allergies: Nasal sprays or antibiotics¹⁴ may help improve the conditions, allowing the management of sunken eyes. 
• Eye injury: Scar management or reconstructive procedures, may help reduce scarring. 
• Cancer: Chemotherapy, radiotherapy, or targeted therapy depending on the type of cancer¹ may help manage the condition contributing to sunken eyes. 
• Sagging brain syndrome: Bed rest and hydration. If the condition is severe, fluid pressure-restoring techniques (e.g., epidural blood patch)¹⁵, may improve fluid pressure. 
• Gastrointestinal issues such as diarrhoea: Antibiotic or antiparasitic medicines⁹ may help reduce dehydration and discomfort caused by gastrointestinal issues. 
• Surgery: Surgery for a VP shunt may be needed if you have sagging brain syndrome or reconstructive surgery to rebuild the upper wall of the eye socket if you have a defect in the orbital wall^8,10.

Home Remedies for Sunken Eyes

Certain home care tips may be helpful in managing sunken eyes and related symptoms, as follows: 

• Cold Compresses for 10-15 Minutes: May help soothe the eyes and improve blood circulation. 
• Cucumber Slices or Tea Bags: May help reduce dark circles under the eyes¹⁶.
• Aloe Vera Gel: May help hydrate under-eye skin, improve collagen production, and enhance skin elasticity¹⁷.
• Hydration: May help keep skin hydrated, improve elasticity² and reduce the appearance of hollowness. 
• Almond Oil: May help reduce dark circles and reduce under-eye wrinkles. 

Note: If your symptoms are not relieved or are worsening after using the sunken eyes remedy methods given above, consult a doctor immediately. 

Tips to Avoid Sunken Eyes

To avoid sunken eyes and related symptoms, you may: 

• Get 7-9 hours of Proper Sleep: This might help you manage dark circles and tiredness⁵.
• Eat Nutritious Food: May help avoid orbital fat loss. 
• Avoid Smoking: May help reduce orbital fat loss¹ and improve skin health. 
• Maintain a Healthy Body Weight: May help reduce hollowness under the eyes¹.
• Get Regular Check-Ups for Underlying Conditions: May help reduce sunken eyes and related symptoms. 

When to See a Doctor?

Medical attention is recommended if sunken eyes occur along with any of the following: 

• Sudden or unexplained hollowing under the eyes. 
• Significant or rapid weight reduction. 
• Persistent dark circles that do not resolve. 
• Severe dehydration symptoms, such as dry mouth and loss of skin elasticity. 
• Eye pain or swelling, or vision changes. 
• Fever or signs of infection. 
• Recent head or facial injury. 
• Headache or dizziness with eye changes. 
• Persistent sunken eyes despite improved sleep and hydration. 

Conclusion

Sunken eyes may often be seen as a harmless cosmetic concern, but they may sometimes reflect the need for lifestyle changes or treatment of underlying health issues. Poor sleep, dehydration, ageing, and nutritional deficiencies are some common causes of sunken eyes, while certain medical conditions may also contribute. Early attention to health habits and appropriate management may help improve your appearance and eye health. If sunken eyes develop suddenly or persist despite lifestyle changes, medical evaluation is recommended to rule out underlying problems. 

Also Read: Burning Eyes: What Causes the Burning Sensation and How to Manage It 

Frequently Asked Questions (FAQs)

References

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