Table of ContentsView AllTable of ContentsSymptomsCausesTreatmentDiagnosisWhen to See a Healthcare ProviderFrequently Asked Questions

Table of ContentsView All

View All

Table of Contents

Symptoms

Causes

Treatment

Diagnosis

When to See a Healthcare Provider

Frequently Asked Questions

“Sunken eyes,” or “enophthalmos,“is a term used to describe the appearance of darker skin directly under your lower eyelids. This makes your eyes look as if they are sitting back inside the eye orbit. You may also hear this referred to as eye hollows. Common causes of sunken eyes include aging, eye trauma, or lack of sleep.

This article covers the symptoms, common causes, and treatment for sunken eyes and discusses when to see a health provider.

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Close up of a woman with dark circles under her sunken eyes.

Symptoms of Sunken Eyes

Symptoms that often accompany sunken eyes include:

The positioning of the eyes on the face can contribute to sunken eyes. Normal eye positioning varies based on age, ethnicity, and sex.For this reason, having sunken eyes does not always indicate a medical problem that needs treatment unless you are looking for a cosmetic change.

Causes of Sunken Eyes

The most common causes of sunken eyes include aging, trauma to the eye, and lack of sleep. Certain medication, including prostaglandin analogs used to treat glaucoma, can also make eyes appear sunken.

Aging

With age, fat content in the eye’s orbital cavity can emulsify, creating more space and making the eyes appear more sunken into the face, with a darker appearance under the eyelids.The skin under the eye also becomes thinner with age, which can contribute to the appearance of enophthalmos.

Eye Trauma

Sunken eyes also can occur due to eye trauma. Causes of eye trauma can occur from:

A type of injury called a blowout fracture—a fracture in one or more of the bones around the eye—is often associated with enophthalmos.

Typically, the eye’s orbit, or eye socket, protects the eye and helps it maintain its positioning. Yet after eye trauma, volume can be lost from the eye’s orbit. The muscles, fat, and tissue around the eye can become displaced. Depending on the extent of the damage, this can lead to a sunken eye.

Many cases of enophthalmos occur within two weeks after trauma. Sometimes, however, it may take a couple of months to appear.

Lack of Sleep

A lack of sleep also can cause sunken eyes. When you don’t get adequate rest, the skin under your eyes may appear darker. You also may havepuffy eyesor eyelids that appear to be drooping.Bloodshot eyes, and eyes that feel more dry than usual, are other potential signs of lack of sleep.

Dark Circles Under the Eyes

What Medications Can Cause Sunken Eyes?

Prostaglandin analogs, a type of medication used for glaucoma, can cause enophthalmos. The antiviral medications used to treat human immunodeficiency virus (HIV) can also cause sunken eyes.

Medications that affect your sleep and keep you awake may also make you appear more tired. This can give the appearance of sunken eyes. Some medicines that may affect sleep include:

Medications that may cause weight loss also could lead to the appearance of sunken eyes. These include:

How to Treat Sunken Eyes

Sunken eyes do not always require treatment.

However, if you do not like how sunken eyes look, you can try to make a few changes on your own to help their appearance. This includes:

There are also cosmetic treatments for sunken eyes, includingdermal fillers. This involves injecting materials such as hyaluronic acid to provide additional volume.The area of skin under the eyes is one area dermal fillers target.

Are There Tests to Diagnose the Cause of Sunken Eyes?

To diagnose the cause of sunken eyes, a healthcare provider will visually inspect your face and your eyes. You may be asked about any medications that you use.Make sure to mention all prescription and nonprescription drugs, including supplements. Let your healthcare provider know about any other ongoing health symptoms.

If you have sunken eyes due to trauma, a healthcare provider may use a computed tomography(CT) scan, magnetic resonance imaging (MRI), orX-rayto assess the damage.

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If the appearance of sunken eyes bothers you and they don’t improve after home measures, such as getting more sleep and hydrating more, it may be helpful to see an eye doctor, such as an ophthalmologist, or other healthcare provider.

On your first eye doctor visit, you may be referred to an oculoplastic surgeon specializing in eye and face surgery if you’re interested in cosmetic treatment.

Summary

Sunken eyes, or enophthalmos, describes the appearance of darker skin directly under your lower eyelids. This makes your eyes look as if they are sunken back into the eye orbit. Common causes of sunken eyes are aging, trauma to the area around the eye, and lack of sleep.

Sunken eyes do not always require treatment. You can try measures at home, such as getting more rest and properly hydrating. You can also get cosmetic treatments, like dermal fillers, if the look of sunken eyes bothers you. Surgery may be part of the treatment if sunken eyes result from trauma.

A Word From Verywell

Sunken eyes may not be serious, but many people want to find a solution to help improve their appearance. If you’re unsure what’s causing your eyes to appear sunken, it’s a good idea to see a healthcare provider to determine the cause and discuss treatment options.

Frequently Asked QuestionsYes, weight loss can cause sunken eyes due to the shift of fat in the face, especially if you lose weight quickly. Rapid weight gain also can cause your eyes to look sunken.Medications used to treat HIV can cause sunken eyes as a side effect.An autoimmune condition calledlinear sclerodermacan also cause sunken eyes.Sunken eyes can be a sign of metastatic breast cancer, although this cause is much less common than aging, eye trauma, or lack of sleep.Learn MoreHIV Facts and Statistics: What You Need to KnowA balanced diet, proper hydration, and getting enough sleep may help get rid of the appearance of sunken eyes. You can also look for eye creams that brighten the skin.

Yes, weight loss can cause sunken eyes due to the shift of fat in the face, especially if you lose weight quickly. Rapid weight gain also can cause your eyes to look sunken.

Medications used to treat HIV can cause sunken eyes as a side effect.An autoimmune condition calledlinear sclerodermacan also cause sunken eyes.Sunken eyes can be a sign of metastatic breast cancer, although this cause is much less common than aging, eye trauma, or lack of sleep.Learn MoreHIV Facts and Statistics: What You Need to Know

Medications used to treat HIV can cause sunken eyes as a side effect.An autoimmune condition calledlinear sclerodermacan also cause sunken eyes.Sunken eyes can be a sign of metastatic breast cancer, although this cause is much less common than aging, eye trauma, or lack of sleep.

Learn MoreHIV Facts and Statistics: What You Need to Know

A balanced diet, proper hydration, and getting enough sleep may help get rid of the appearance of sunken eyes. You can also look for eye creams that brighten the skin.

11 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Association for Pediatric Ophthalmology and Strabismus.Blowout fracture.Saravanan A, Patel BC.Enophthalmos. In:StatPearls. StatPearls Publishing; 2022.Review of Ophthalmology.PAP: New concerns of prostaglandin use.Mawatari Y, Fukushima M, Kawaji T.Changes in sunken eyes combined with blepharoptosis after levator resection.Plast Reconstr Surg Glob Open. 2017;5(12):e1616. doi:10.1097/GOX.0000000000001616American Academy of Sleep Medicine.How lack of sleep affects your eyesight.National Jewish Health.Medications that can cause insomnia.Arterburn D, Sofer T, Boudreau DM, et al.Long-term weight change after initiating second-generation antidepressants.J Clin Med. 2016;5(4):48. doi:10.3390/jcm5040048American Society of Plastic Surgeons.What are dermal fillers?American Academy of Ophthalmology.Eye exam and vision testing basics.Guzman N, Vijayan V.HIV-associated lipodystrophy. In:StatPearls. StatPearls Publishing; 2022.El-Khazen D, Marchand M, Javidi S, et al.Enophthalmos as the initial systemic finding of undiagnosed metastatic breast carcinoma.Int Med Case Rep J. 2021;14:25-31. doi:10.2147/IMCRJ.S282113

11 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Association for Pediatric Ophthalmology and Strabismus.Blowout fracture.Saravanan A, Patel BC.Enophthalmos. In:StatPearls. StatPearls Publishing; 2022.Review of Ophthalmology.PAP: New concerns of prostaglandin use.Mawatari Y, Fukushima M, Kawaji T.Changes in sunken eyes combined with blepharoptosis after levator resection.Plast Reconstr Surg Glob Open. 2017;5(12):e1616. doi:10.1097/GOX.0000000000001616American Academy of Sleep Medicine.How lack of sleep affects your eyesight.National Jewish Health.Medications that can cause insomnia.Arterburn D, Sofer T, Boudreau DM, et al.Long-term weight change after initiating second-generation antidepressants.J Clin Med. 2016;5(4):48. doi:10.3390/jcm5040048American Society of Plastic Surgeons.What are dermal fillers?American Academy of Ophthalmology.Eye exam and vision testing basics.Guzman N, Vijayan V.HIV-associated lipodystrophy. In:StatPearls. StatPearls Publishing; 2022.El-Khazen D, Marchand M, Javidi S, et al.Enophthalmos as the initial systemic finding of undiagnosed metastatic breast carcinoma.Int Med Case Rep J. 2021;14:25-31. doi:10.2147/IMCRJ.S282113

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

American Association for Pediatric Ophthalmology and Strabismus.Blowout fracture.Saravanan A, Patel BC.Enophthalmos. In:StatPearls. StatPearls Publishing; 2022.Review of Ophthalmology.PAP: New concerns of prostaglandin use.Mawatari Y, Fukushima M, Kawaji T.Changes in sunken eyes combined with blepharoptosis after levator resection.Plast Reconstr Surg Glob Open. 2017;5(12):e1616. doi:10.1097/GOX.0000000000001616American Academy of Sleep Medicine.How lack of sleep affects your eyesight.National Jewish Health.Medications that can cause insomnia.Arterburn D, Sofer T, Boudreau DM, et al.Long-term weight change after initiating second-generation antidepressants.J Clin Med. 2016;5(4):48. doi:10.3390/jcm5040048American Society of Plastic Surgeons.What are dermal fillers?American Academy of Ophthalmology.Eye exam and vision testing basics.Guzman N, Vijayan V.HIV-associated lipodystrophy. In:StatPearls. StatPearls Publishing; 2022.El-Khazen D, Marchand M, Javidi S, et al.Enophthalmos as the initial systemic finding of undiagnosed metastatic breast carcinoma.Int Med Case Rep J. 2021;14:25-31. doi:10.2147/IMCRJ.S282113

American Association for Pediatric Ophthalmology and Strabismus.Blowout fracture.

Saravanan A, Patel BC.Enophthalmos. In:StatPearls. StatPearls Publishing; 2022.

Review of Ophthalmology.PAP: New concerns of prostaglandin use.

Mawatari Y, Fukushima M, Kawaji T.Changes in sunken eyes combined with blepharoptosis after levator resection.Plast Reconstr Surg Glob Open. 2017;5(12):e1616. doi:10.1097/GOX.0000000000001616

American Academy of Sleep Medicine.How lack of sleep affects your eyesight.

National Jewish Health.Medications that can cause insomnia.

Arterburn D, Sofer T, Boudreau DM, et al.Long-term weight change after initiating second-generation antidepressants.J Clin Med. 2016;5(4):48. doi:10.3390/jcm5040048

American Society of Plastic Surgeons.What are dermal fillers?

American Academy of Ophthalmology.Eye exam and vision testing basics.

Guzman N, Vijayan V.HIV-associated lipodystrophy. In:StatPearls. StatPearls Publishing; 2022.

El-Khazen D, Marchand M, Javidi S, et al.Enophthalmos as the initial systemic finding of undiagnosed metastatic breast carcinoma.Int Med Case Rep J. 2021;14:25-31. doi:10.2147/IMCRJ.S282113

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