Hypertelorism is an abnormally increased distance between two eyes.
Usually it is used to refer to widely spaced eyes in a variety of syndromes
Abnormal increase in thé inter orbital distance is not a disease but outcome of some underlying disease, It occours due to overdevelopment of the lesser wings of the sphenoid , ethmoidal air cells or a tumor or brain or brain fluid[CSF] coming out or occupying the space between two eyes leading to increase in the inter orbital distance. Normal interorbital distance at birth is 18mm, and in adults it usually 24 -26mm. depending upon the distance between two eyes it is classifeied as mild moderate or severe.

Mild 30 to 35 mm
Moderate 36 to 40 mm
Severe more than 40 mm
What causes Hypertelorism?

Usuel causes of hypertelorism are:

1. Basal or nasofrontal or naso-orbital encephalocele
2. Craniosynostosis
3. Rare craniofacial clefts [central]
Tumors of sphenoid and ethmoid
Commonly hypertelorism is bilateral but some times it can be unilateral [displacing one eye only]
It occours usually in tumors, naso-orbital encephalocele or unilateral craniofacial clefts.

Treatment:

Treatment of hypertelorism can be divided into two parts.

1 Treatment of the underlying pathology or disease.
2 Corrections of displaced orbits
Surgery is performed under General anesthesia, by a team of plastic surgeon and neurosurgeon. Plastic surgeon makes an incision from one ear to apposite ear and dissects out skin flap. Then Neuro-surgeon makes a craniotomy and protects dura, plastic surgeon does rest of the work cutting the bones around the eye boll. From the centeral part, excss bone is removed and both the orbits are mobilised in to proper position. Craniotomy is fixed back by neurosurgeon and skin is closed.post operatievely pts is monitored in ICU for 24 – 48 hrs, usually 2 units of blood is required in the operation. Operation lasts for about 5-6 hrs. With advances in anaesthesia and instrumentation surgery has become quite safe.