Injury to the face or the bones around the eyes can cause the eyes to appear sunken. Whilst the injury heals over weeks or months. The eye continues to sink for months after surgery causing a hollowing appearance.
The eye socket is a solid cone surrounding the eye, made up of 7 bones any of which can break causing a sunken look. Sports injuries are a common cause particularly those with a ball, stick or moving body parts. Assault is a common injury causing fracture of the eye socket, cheek or nose.
There are several types of eye socket fractures including, rim fracture, floor fracture, wall fractured, and trapdoor fracture. Patients complain of pain, swelling, black eye, bulging eye, red eye, sunken eye, numbness in the eyelids, forehead, cheeks, or upper lip/teeth area, double vision, blurred vision, or decreased vision, difficulty looking up, down or to the sides, a drooping eyelid, sensitivity to light, a flattened cheek, usually painful when opening the mouth, puffy skin around the eye, nausea and vomiting – varying with type and severity of the fracture.
Repair of fractured eye socket is by surgery, carried out from the inside of the eyelid leaving no visible scar. In some cases, it should be carried out urgently, whilst in others, it is delayed for 7 – 10 days. If surgery is not undertaken, the eye may gradually sink into the socket over months causing a sunken/hollowed appearance.
During surgery, a prosthetic such as a titanium plate may be used to repair the break along with reinforcing mesh. Most people return to work 7-10 days after surgery.