ABSTRACT
The term orbital hypertelorism (ORH) implies “widely apart orbits.” This may also
be associated with the abnormal vertical orientation of the orbits (dystopia). This
deformity may be unilateral or bilateral, symmetric or asymmetric and may be present
in a variety of craniofacial conditions. The treatment is primarily carried out for
aesthetic reasons. The timing of treatment is dictated by the underlying condition
and the type of procedure envisaged. The mainstay of treatment consists of moving
the orbits medially to near normal position. This is accomplished by either an orbital
translocation or facial bipartition technique. The choice of procedure is governed
by the shape of the maxillary arch and associated occlusal conditions. We must differentiate
between the telecanthus (also called pseudo-hypertelorism) and a true ORH as the management
differs in these two conditions. The ORH involves extensive intracranial and extracranial
operation whereas the telecanthus correction is relatively simpler surgery. The article
will discuss the aetiology, classification, presentation, treatment options, timing
of surgery and the choice of surgical procedures. Illustrative case reports with long-term
results will be used to explain the management of these patients.
KEY WORDS
Box osteotomy - cranial bone graft - facial bipartition - intra-cranial and extra-cranial
procedure - lateralization of orbit - orbital socket - telecanthus or pseudo-hypertelorism
- vertical dystopia
