Overview
Orbital hypertelorism is a congenital condition characterized by an abnormally increased distance between the eyes (orbits). It is often noticeable at birth and may be associated with craniofacial syndromes or other congenital anomalies. While it primarily affects facial appearance, severe cases can impact vision, dental alignment, and psychosocial well-being.
In Korea, orbital hypertelorism is managed by craniofacial surgeons, pediatric specialists, and ophthalmologists, with treatment options ranging from monitoring in mild cases to corrective surgery in severe cases.
Key Facts
➤ Orbital hypertelorism refers to eyes being spaced wider than normal.
➤ Can occur isolated or as part of craniofacial syndromes such as Apert syndrome, Crouzon syndrome, or craniofrontonasal dysplasia.
➤ Severity varies – mild cases may be mainly cosmetic, while severe cases can affect ocular function.
➤ In Korea, early assessment and intervention help optimize functional and cosmetic outcomes.
➤ Can be detected through physical examination, imaging, or genetic evaluation.
What is Orbital Hypertelorism?
Orbital hypertelorism is defined by an increased distance between the medial orbital walls, often measured by:
- Interorbital distance (IOD) – the distance between the inner corners of the eyes.
- Outer orbital distance (OOD) – the distance between the outer corners of the eyes.
➔ Causes are usually developmental abnormalities in craniofacial bone growth during fetal development.
Associated features may include:
- Midface hypoplasia or cleft lip/palate.
- Nasal deformities – broad or flat nose.
- Dental misalignment.
- Other syndromic features depending on the underlying condition.
Symptoms Related to Orbital Hypertelorism
➤ Widely spaced eyes noticeable at birth or early childhood.
➤ Facial asymmetry or midface flattening.
➤ Vision problems such as strabismus (misaligned eyes) in some cases.
➤ Psychosocial challenges due to appearance.
➤ Occasionally associated with cranial malformations or syndromes.
Causes / Possible Causes
Genetic and Developmental Causes
➤ Syndromic craniofacial anomalies – Apert, Crouzon, or craniofrontonasal dysplasia.
➤ Isolated developmental anomaly – occurs without other syndromic features.
➤ Genetic mutations affecting cranial and orbital bone growth.
Environmental Factors
➤ Rarely, maternal exposure to teratogens during pregnancy can contribute.
➤ Premature birth or intrauterine growth abnormalities may influence craniofacial development.
Risk Factors
➤ Family history of craniofacial syndromes.
➤ Known genetic mutations affecting cranial or orbital development.
➤ Prenatal exposure to certain teratogens (e.g., drugs, alcohol).
➤ Syndromic conditions associated with other malformations.
Complications
Orbital hypertelorism may lead to:
➤ Cosmetic concerns and psychosocial stress.
➤ Vision problems such as strabismus or impaired binocular vision.
➤ Midface and dental malformations affecting chewing and speech.
➤ Airway or nasal issues if associated with other craniofacial anomalies.
➤ Potential need for multiple corrective surgeries during growth.
When Should I See My Doctor?
Medical evaluation is recommended if:
➤ A child is born with widely spaced eyes or abnormal facial features.
➤ There are associated vision or developmental concerns.
➤ Craniofacial syndromes are suspected based on family history or physical features.
➤ Cosmetic concerns are significant enough to affect psychosocial development.
➤ Multidisciplinary assessment is needed for surgical planning.
Care and Treatment
Observation and Monitoring
➤ Mild cases may require only periodic monitoring.
➤ Ophthalmologic assessments to ensure normal vision development.
Surgical Management
➤ Craniofacial corrective surgery – to reposition the orbits closer together.
➤ Timing of surgery – often performed between ages 3–8, depending on severity.
➤ Associated procedures – correction of cleft palate, nasal deformities, or orbital asymmetry.
➤ Multistage surgeries may be needed in complex syndromes.
Supportive Care
➤ Genetic counseling for families with syndromic causes.
➤ Psychological support to manage self-esteem and social challenges.
➤ Vision therapy or strabismus treatment if eye alignment is affected.
Preventive Measures
➤ Early genetic evaluation for at-risk families.
➤ Prenatal care to minimize exposure to teratogens.
➤ Regular pediatric monitoring to detect associated craniofacial issues early.
Treatment Options in Korea
Korean hospitals and craniofacial centers provide:
Diagnostic Services
➤ 3D CT scans and MRI for precise measurement of orbital distance.
➤ Genetic testing to identify syndromic causes.
➤ Ophthalmology evaluation for visual function.
➤ Multidisciplinary assessment including ENT, maxillofacial, and craniofacial specialists.
Surgical and Therapeutic Care
➤ Orbital box osteotomy or craniofacial remodeling for severe cases.
➤ Correction of associated nasal or midface deformities.
➤ Post-surgical rehabilitation and follow-up for optimal cosmetic and functional outcomes.
➤ Psychosocial support and counseling for patients and families.
✅ In summary: Orbital hypertelorism is a congenital condition marked by abnormally spaced eyes. It may occur isolated or as part of syndromes, affecting appearance, vision, and psychosocial well-being. In Korea, early diagnosis, genetic evaluation, and craniofacial surgery ensure effective management and improved quality of life.
