Is There Any Way To Move My Eyes Closer Together Without Major Surgery?

Q: Dr. Eppley, I am looking for a correction for my hypertelorism (wide set eyes). I have measured my intercanthal distance at 36 mm, which I believe puts me in the “mild/moderate” range. While I will pursue it if it is the only option possible, I would love to avoid large-scale craniofacial surgery if I could. I have heard of surgeons moving eyes up or down a few mm using implants and wall burring. Would the same be possible for my eyes, simply horizontally? I would love any of your advice on the matter in terms of solutions to my problem!

A: Thank you for your inquiry. In answer to your questions, let me first address moving the eyes or changing the perception of the orbits by some alteration inside the orbital bones. While some vertical movement of the eyeball can be done (more upward than downward), there is no horizontal movement that can be done. The location of medial rectus muscle and the ethmoid and lacrimal bones prevents any inward movement of the eye by changing the intraorbital space volume. There is also the limits of the medial canthal tendon and the inner eye aperture. That can not be moved inward unless the bones are moved.

Your diagnosis of hypertelorism is correct and by appearance and intercanthal measurements you would be classified as a Type 1 hypertelorism. Such mild cases of hypertelorism are almost never surgically corrected due to the magnitude of the operation. Hypertelorism surgery requires a large scalp incision, a frontal craniotomy and removal of interorbital bone to move the orbital boxes inward. While I would have no doubt that this operation can be successful in you, the risks of infection, forehead bony irregularities, temporal hollowing, permanent scalp scar and frontal facial nerve injury all make this operation reserved for those patients that have more severe Type 2 and 3 hypertelorism problems.

In short, there are no simple solutions to your hypertelorism and the aesthetics of your case do not justify the major surgery needed to improve it.

Dr. Barry Eppley