Hypertelorism is a term that refers to an increased distance between two body parts, and ocular hypertelorism is specific to the eye sockets. Hypertelorism is not a condition itself, but a symptom that occurs due to either a mass pushing the two orbits apart, a cleft in the bone between the eyes or as part of a syndrome such as craniosynostosis and frontonasal dysplasia.
In normal fetal development, the eye sockets develop laterally and rotate to their normal midline position. In orbital hypertelorism, the eye sockets do not rotate into their normal position.
Symptoms
An individual with hypertelorism has abnormally wide-set eyes.
Diagnosis
Hypertelorism is typically diagnosed at birth through a physical exam. CT scans, MRIs and genetic testing can help determine the underlying cause of the symptom.
Treatment
It is important for children with hypertelorism to be treated by a team of specialists to diagnose the underlying cause of these symptoms, which can vary from mild to severe. Wide-set eyes can be treated through facial reconstructive surgery by our team at the North Carolina Cleft and Craniofacial Center, who provide comprehensive care through surgery, treatment and long-term checkups.
In mild cases of orbital hypertelorism, we may recommend an extracranial correction, where the bones of the inner portions of the nose and eye socket are brought closer together without entering the skull. In more severe cases, our plastic surgeon and neurosurgeon may perform intracranial and extracranial procedures. In this procedure, an ear-to-ear incision is made, the forehead bone is temporarily removed and the brain retracted, and the excess bone beneath the eyes is removed. The eye sockets are then cut and moved closer together and soft tissue is replaced. If other areas of the face, such as the nose and upper jaw, are displaced, then those areas can be moved in coordination with the orbit and brought together.
Follow-up procedures may be necessary as your child grows. Surgeries to treat hypertelorism are available at the age of five or older unless your child has severe symptoms that affect the function of the eyes.
