What do sunken eyes look like in a dehydrated 3-month-old infant?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: January 3, 2026 • View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

What Sunken Eyes Look Like in a Dehydrated 3-Month-Old Infant

Sunken eyes appear as eyes that are visibly recessed or depressed into the orbital sockets, with a hollowed-out appearance around the periorbital area, representing one of the most reliable clinical signs of moderate to severe dehydration in infants. 1, 2

Physical Appearance

  • The eyes appear to sit deeper in the eye sockets than normal, creating a visible depression or hollow appearance around the orbital rim 1, 2
  • The periorbital tissues look deflated or collapsed, with loss of the normal fullness around the eyes 3
  • Parents or caregivers often describe the eyes as looking "sunken in" or "hollow" compared to the child's normal appearance 2
  • The finding is best appreciated by comparing the current appearance to the infant's baseline appearance when well-hydrated 4

Clinical Significance

  • Sunken eyes are one of the four most valid clinical signs for detecting dehydration in infants and young children, along with decreased skin turgor, weak pulse, and altered general appearance 1
  • This finding correlates with fluid deficits of 5% body weight or greater (moderate dehydration) 2, 3
  • Sunken eyes have a likelihood ratio of approximately 2.5-4.1 for predicting clinically significant dehydration when present 4
  • The sign becomes more pronounced with increasing severity of dehydration, appearing more frequently in children with 5-9% fluid deficit and nearly universally in those with >10% deficit 1

Assessment Context

  • Sunken eyes should never be assessed in isolation but rather as part of a constellation of clinical findings 1, 4
  • The most accurate assessment combines sunken eyes with evaluation of skin turgor, capillary refill time, respiratory pattern, and general appearance 1, 4, 5
  • In a 3-month-old infant, also assess the anterior fontanelle (which may be sunken in dehydration), mucous membrane moisture, tear production, and time since last urination 3

Common Pitfalls

  • Do not confuse normal anatomic variation or familial features (such as deep-set eyes) with pathologic sunken eyes from dehydration 4
  • The finding is more difficult to assess in infants with significant subcutaneous fat loss from chronic malnutrition, which can create a similar appearance 2
  • Crying or agitation can temporarily alter the appearance of periorbital tissues, so assess when the infant is calm if possible 4

References

2
Research

How valid are clinical signs of dehydration in infants?

Journal of pediatric gastroenterology and nutrition, 1996

4
Research

Is this child dehydrated?

JAMA, 2004

5
Research

Diagnosis and management of dehydration in children.

American family physician, 2009

Related Questions

How do you assess skin turgor in a 3-month-old infant?
What is the most likely diagnosis for a 6-month-old infant with a 7-day history of diarrhea, presenting with decreased skin turgor, sunken eyes, cold extremities, tachycardia, and hypotension?
What are the next steps for a 45-day-old infant presenting with diarrhea?
What is the most likely diagnosis for a pediatric patient presenting with severe dehydration, delayed capillary refill, decreased skin turgor, sunken eyes, crying without tears, decreased urine output, hypotension, tachycardia, and tachypnea?
What is the percentage of dehydration in a 6-month-old child with a depressed fontanelle, sunken eyes, normal vitals, and eagerness to drink?
Is Staphylococcus haemolyticus considered a blood pathogen, especially in patients with compromised immune systems or medical devices like prosthetic devices or indwelling catheters?
Can hypothyroidism (underactive thyroid) cause tremors in adults, particularly women and older adults?
What is the best course of action for a 3-year-old patient with Acute Lymphoblastic Leukemia (ALL) who is Minimal Residual Disease (MRD) negative (<0.01%) at day 29 post-induction Chemotherapy (CT)?
What is the appropriate management for a patient presenting with fever and rash, considering various potential causes including infectious, autoimmune, and allergic conditions?
How to manage bleeding in a diabetic patient undergoing nail removal procedure?
What is the best type of suturing technique for wound laceration in an emergency setting?

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.

Ask Question