Can My Vertical Orbital Dystopia Be Treated?

Q: Dr. Eppley, I suffer from vertical orbital dystopia, my left eye being slightly lower than my right. I have been told bone contouring of the upper left eye orbit would help with the asymmetry, bringing both my upper orbits to to the same level. Also fillers and possibly an implant under the left eye, to bring the eye up slightly to more the same level.

This is an issue that has destroyed my whole life, please would it be possible to help. It is insane how no oculoplastic surgeons seem to offer the treatment you do and seem completely ignorant about it.

A: Thank you for your inquiry and sending your picture. With what appears to be about a 5mm vertical orbital dystopia, that is within the range of being treatable by orbital floor-rim implant augmentation as well as supraorbital rim bone reshaping. To determine the exact treatment plan you would need to get a 3D CT scan of your orbits which will provide the accurate information as to how to exactly proceed down to the millimeter level.

Having treated numerous cases just like yours, good improvement is possible. You may never get the eyes perfectly level (there are limits as to how much the eye can be safely raised) but visible improvement is possible nonetheless.

I will have my assistant pass along a document which will describe how to find a place locally to have the 3D CT scan for which we can then provide the order to the chosen facility for you to get the scan.

Dr. Barry Eppley
Indianapolis, Indiana