It is Possible To Bring The Eyes Closer Together In An Adult with Orbital Box Osteotomies?

Q: Dr. Eppley, You said that it was impossible or not recommended to bring the eyes closer in those suffering from hypertelorism 1. But could it be possible to increase the distance between the eyes for those who suffer mild hypotelorism? 

A: Orbital box osteotomies in adults, whether it is to bring the eyes closer together or further apart, are treacherous from an aesthetic standpoint. Numerous aesthetic tradeoffs exist (e.g., long coronal scalp scar, bony irregularities) for which the tradeoffs do not seem worth the benefit. It is not impossible, just not advised.

To illustrate that point I saw a patient recently who had orbital box osteotomies as an adult for mild hypertelorsim. She is now on her 5th revisional surgery to manage the aesthetic tradeoffs. Her eyes are better but…

Dr. Barry Eppley

Indianapolis, Indiana