Q: Dr. Eppley, I have deep set eyes and I don’t like them at all. What are the options for me? I have a very hollow appearance to my eyes and I want to improve it.
A: When it comes to trying to improve deep set eyes, there are few options. You can not move the eyeball forward by any method, all that can be done is to reduce the surrounding orbital bone along the brow ridge and the lateral orbital rim. Depending upon the prominence of the brow ridge, this can be particularly effective. It is important, however to separate the terms ‘deep set eyes’ and ‘hollow eyes’ for they represent different orbital morphologies. A deep set eye is when the globe (eyeball) sits far behind the surrounding orbital rims, particularly the superior and lateral orbital rims. Reducing the projection of the surrounding overprojecting bone is what can make the eye seem to come forward. Conversely, a hollow eye appearance implies that the relationship between the globe and the surrounding orbital rims is normal but that there is a lack of fat in the lid areas, having them retract posteriorly. The hollow eye or lid deficiency/retraction can be treated by fat injections.
Dr. Barry Eppley