Genetics
Genetics play a role in the incidence of enophthalmos. If sunken eyes are common among family members, chances are, it is inherited or is because of the DNA. Some genetic factors responsible for eyelid sagging include the skin type, the amount of collagen and elastin in the body, and other growth factors, including the thymine–guanine-interacting factor 1 (TGIF1).
The common occurrence of sunken eyes among family members, especially when it’s bilateral, makes it harder to recognize congenital enophthalmos. Nevertheless, it does occur, though sometimes, it coincides with other autosomal recessive disorders resulting from mutations in the genes or mutations in excision-repair cross-complementing (ERCC) genes which are essential in correcting defects during DNA replication.
In cases when enophthalmos is unilateral, the asymmetry of the orbits and globes may be more prominent. After all, if it’s a unilateral case of sunken eyes, simply measuring the lateral edge of the anteroposterior axis between the two globes is enough to tell that one of them is hollowed. The hollow eye may also be associated with other conditions, so it’s best to get it diagnosed as early as possible. The best way to spot relative enophthalmos is to take a chin-up position when checking asymmetry.
