Orbital Hypertelorism

Q: Dr. Eppley, My eyes are too wide- apart which is the biggest regret in my life. I have normal to level 1 of hypertelorism (advised by one doctor before) and I think I am close to no deformity. I would like to know if orbital box osteotomy can be performed in non-deformed patients through milder approaches, like via infra-orbital or oral incisions since my inter-pupillary distance is not as wide as the deformed cases. In my home county and East Asia, there is very rare information about this procedure. I would like to know if any osteotomy procedures can be done to my eyes. Much appreciated and awaiting eagerly for your response. Many thanks doctor!

A: Orbital translocations, aka orbital box osteotomies, can only be performed through a coronal/scalp incision with a frontal bone flap craniotomy removal. There are no effective more limited ways to do an orbital hypertelorism procedure. The only less invasive way that the eyes can be made to appear closer together is with some camouflage procedures such as nasal bridge augmentation and/or medial canthoplasties/medial epicanthoplasties. These small changes to the nose and inner eyes, particularly if done together, can often have major influence on how close the eyes may appear.

Dr. Barry Eppley

Indianapolis, Indiana