What is Enophthalmos?
Enophthalmos is when one eye is deeper into the eye socket compared to the other eye. The condition is also called “sunken eyes”, and can be congenital (present at birth) or acquired (caused by something that happens to you). It can affect one or both eyes.
Enophthalmos occurs due to trauma, disease, and in patients with cancer metastasis (cancer that has spread).
Key Points
- Enophthalmos describes a condition when one eye appears sunken within the orbit.
- Enophthalmos can be congenital (present at birth) or acquired (caused by something that happens to you).
- Causes of the condition include trauma and disease, and is often treated with surgery.
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Understanding Enophthalmos
Congenital enophthalmos may occur due to silent sinus syndrome. Secondary enophthalmos is often due to trauma to the face, such as after a car accident or fight. Other causes can include:
- Surgery around the eye socket
- Radiation therapy to the head over long periods
- Dehydration
- Inflammation or infection
- Metastatic cancers
- Diseases such as Parry–Romberg syndrome and HIV
- Sclerodoma (an autoimmune condition)
- Certain glaucoma medications
- Bone loss due to aging
Symptoms
In most cases of congenital deformities and trauma, the condition gets worse over time. The related swelling and inflammation following trauma may prevent complete repair. Congenital enophthalmos continues to progress as specific parts of the face develop and others do not.
Symptoms depend on the cause and severity but the most common are facial asymmetry and double vision. Other signs include:
- Trouble with focus
- Dry eyes
- Sagging upper eyelids (ptosis)
- Deep groove in eyelids (sulcus)
Diagnosis
Neuroimaging is crucial for diagnosis, and other testing may be needed depending on the suspected cause. For instance, a suspected orbital tumor can be diagnosed on neuroimaging, but a biopsy may also be recommended.
A Hertel exophthalmometer can measure and manage the degree of enophthalmos.
Treatment
Treatment depends on the cause, but almost always includes surgery to rebuild the orbit.
