Why Do People's Eyes Sink In When They Get Older?

According to a study published in the Aesthetic Surgery Journal, the volume of the bony eye socket, or orbit, increases with age due to bone resorption. This is one of several significant anatomical changes that explain why people's eyes sink in when they get older, a condition known as enophthalmos.

Quick Summary

Age-related changes in facial anatomy, including the enlargement of the eye socket, the atrophy of periorbital fat, and the weakening of surrounding tissues, cause the eyes to appear sunken and hollowed.

Key Points

• Skeletal Expansion: The bony eye sockets expand and recede with age, reducing support for the eyes.

• Fat Atrophy: The periorbital fat around the eyes diminishes, causing volume loss and allowing the eyeball to recede.

• Soft Tissue Weakening: The orbital septum weakens, potentially causing fat to bulge elsewhere while creating hollows in the tear trough.

• Collagen Loss: Decreased collagen and elastin lead to thinner, looser skin around the eyes, highlighting underlying volume loss.

• Lifestyle Factors: Dehydration and significant weight loss can worsen the appearance of sunken eyes.

• Cosmetic Solutions: Dermal fillers are a non-surgical option, while surgery offers more permanent results to restore volume.

The Anatomy of Aging Eyes

The periorbital region around the eye undergoes multi-layered changes with age. These changes in bone, fat, and soft tissues contribute to a hollowed-out appearance.

Skeletal Remodeling: The Foundation Changes

One key change is the remodeling of the facial skeleton. The bony orbit, or eye socket, widens and recedes over time, particularly in the upper-inner and lower-outer areas. This expansion provides less structural support for the surrounding tissues, contributing to deeper tear troughs and a hollower look. This age-related bony change is a primary cause of sunken eyes, sometimes called "senile enophthalmos".

Periorbital Fat Atrophy: The Volume Deficit

Loss of facial fat is another major factor. The periorbital fat pads, which cushion the eyeball, shrink with age, creating more space behind the eye and causing the eyeball to shift backward. This volume loss is particularly noticeable under the eyes, making the orbital rim more prominent and the tear trough area more hollow.

Common Causes of Periorbital Fat Atrophy

• Natural Aging: The most common reason for fat pad shrinkage.
• Significant Weight Loss: Can accelerate fat loss in the face.
• Dehydration: Can cause temporary sunken appearance.
• Genetics: Predisposition to less periorbital fat.

Orbital Septum Weakening: The Prolapse Effect

The orbital septum, a membrane that holds orbital fat in place, weakens with age. As it thins, fat can bulge forward (creating bags) while other areas become hollow, contributing to a tired and hollowed look.

Age-Related Periorbital Changes: A Comparison

Feature	Younger Face	Older Face
Orbital Bone Structure	Provides robust support.	Orbit enlarges and recedes, reducing support.
Periorbital Fat Pads	Ample volume, smooth appearance.	Atrophy and shrink, leading to hollows.
Orbital Septum	Taut and strong.	Weakens, allowing fat prolapse (bags) and potentially deepening hollows.
Skin Elasticity and Collagen	High levels, firm skin.	Decreased, leading to laxity and accentuating hollows.
Overall Appearance	Bright, refreshed.	Often appears tired, hollowed, or shadowed.

The Role of Lifestyle and External Factors

Lifestyle and environmental factors can worsen sunken eyes. Chronic dehydration and sleep deprivation can make eyes appear more hollow. Sun exposure damages skin collagen and elastin, while significant weight loss reduces facial fat, making hollows more noticeable.

What Can Be Done About Sunken Eyes?

Several options are available to address the appearance of sunken eyes:

• Dermal Fillers: Injectable hyaluronic acid fillers restore volume in the tear trough area.
• Fat Transfer: Uses a person's own fat to restore volume, offering longer-lasting results.
• Blepharoplasty: Eyelid surgery that can involve adding or repositioning fat to restore contour.
• Proper Hydration and Diet: Maintaining a healthy lifestyle can help prevent an accelerated hollowed look.

Conclusion: A Multi-Factorial Process

Sunken eyes with age are primarily caused by skeletal remodeling (expanding eye sockets), fat atrophy (diminishing periorbital fat), and weakening soft tissues (orbital septum). These changes lead to volume loss and reduced structural support, resulting in a hollowed look. While lifestyle factors can contribute, it is a natural part of facial aging. Various cosmetic and medical interventions can help rejuvenate the eye area.

Understanding the Causes of Sunken Eyes

• Bone Remodeling: The bony orbit expands and recedes with age, reducing forward support for the eye.
• Fat Atrophy: Periorbital fat diminishes, causing volume loss and allowing the eyeball to sink backward.
• Weakening Orbital Septum: The membrane holding eye fat weakens, potentially causing fat to bulge and deepening hollows below.
• Skin and Muscle Laxity: Loss of collagen and elastin, along with muscle weakening, contributes to a looser appearance.
• Lifestyle and Genetics: Dehydration, weight loss, and genetics can exacerbate the aging process.

Frequently Asked Questions

What is the medical term for sunken eyes?

The medical term for sunken eyes is enophthalmos. While trauma or disease can cause it, age-related changes are a common reason.

Can dehydration cause my eyes to sink in?

Yes, severe dehydration can cause eyes to appear temporarily sunken due to fluid loss. Staying hydrated helps maintain a fuller appearance.

Does weight loss make sunken eyes worse?

Significant weight loss can accentuate sunken eyes by reducing facial fat, which makes the underlying bone structure more visible.

Are sunken eyes a sign of a serious health problem?

Generally, age-related sunken eyes are a normal cosmetic change. However, sudden onset or accompanying symptoms warrant a doctor's visit to rule out underlying medical issues.

Can fillers fix sunken eyes?

Yes, dermal fillers like hyaluronic acid effectively restore lost volume in the tear trough area, reducing the appearance of hollowness.

How can I prevent my eyes from sinking in?

While aging is inevitable, maintaining hydration, healthy weight, sufficient sleep, and sun protection can help manage contributing factors.

Is surgery an option for sunken eyes?

Yes, procedures like fat transfer or blepharoplasty (designed to add volume) offer more permanent solutions.

Frequently Asked Questions

What is the medical term for sunken eyes?

The medical term for sunken eyes is enophthalmos. While this condition can sometimes result from trauma or illness, age-related orbital bone and tissue changes are a very common cause.

Can dehydration cause my eyes to look sunken?

Yes, chronic or severe dehydration can lead to sunken eyes. When the body lacks sufficient fluids, it can cause a temporary loss of volume, making the eyes appear more hollowed.

Do sunken eyes indicate a serious health problem?

In many cases, age-related sunken eyes are a natural, harmless cosmetic change. However, if the condition develops suddenly or is accompanied by other symptoms like vision changes, it is wise to consult a doctor to rule out any underlying medical conditions.

Can weight loss contribute to sunken eyes?

Yes, significant or rapid weight loss can worsen the appearance of sunken eyes. A major reduction in body fat, including the fat pads in the face, can cause the orbital rim and other facial bones to become more pronounced.

Can cosmetic procedures fix sunken eyes?

Yes, several cosmetic procedures can address sunken eyes. Dermal fillers, which use injectable substances like hyaluronic acid, are a popular non-surgical option to restore lost volume. Surgical options like fat transfer or blepharoplasty can also provide longer-lasting results.

Why do some older people have puffy eyes instead of sunken eyes?

This can happen due to the weakening of the orbital septum, a membrane that holds orbital fat in place. While some fat diminishes, the septum weakens and allows other fat pads to prolapse forward, creating eye bags and puffiness, sometimes alongside hollows.

What role does genetics play in sunken eyes?

Genetics can play a significant role. Some individuals are predisposed to having less periorbital fat or a particular facial bone structure, which can cause them to have sunken eyes at a younger age or experience the condition more prominently as they age.