Telecanthus is a condition where the inner corners of the eyes are spaced further apart than usual. Whilst it may appear to impact only appearance, this small facial difference can have some profound effects on mental health and social life. If you or someone you know is affected by telecanthus, understanding its impact on self-esteem, emotional wellbeing and daily life is crucial. 

This condition, although in itself benign, can lead to self-consciousness, social anxiety and even bullying, especially in children and adolescents. It may also influence professional and academic experiences. However, coping strategies, psychological support, and in some cases, medical interventions can help affected individuals to navigate these challenges. Read on to explore the psychosocial effects of telecanthus and discover ways to support those affected by it. 

Introduction

Telecanthus is a condition in which the inner corners of the eyes are set wider apart than usual. Unlike hypertelorism, a condition in which the actual eye sockets are spaced wider apart, telecanthus does not affect the actual bones of the face. It is a condition in which the soft tissue around the eyes is stretched or positioned differently, which in turn makes the eyes appear further apart. Telecanthus is usually present when you are born, as it is typically caused by a genetic mutation, but can also be caused by trauma (such as an injury to the face or surgery in the area). While it doesn’t usually impact vision and is a generally benign disorder, telecanthus does impact a person's appearance, which can sometimes lead to self-consciousness or emotional distress. 

Psychological effects

Below, we will go over some of the psychological effects which may be associated with having telecanthus. 

Self-esteem and body image

As with many facial differences, telecanthus may cause issues with self-esteem, body image and overall confidence. It may feel embarrassing to be visibly different to others, despite the condition not affecting physical health. Studies have shown that those with visible facial differences are at higher risk of low self-esteem and self-consciousness.¹ 

Issues with self-esteem are often exacerbated in teens, as the vast changes that they undergo both physically and socially during the adolescent period have a major effect on self-perception. Research shows that 37% of teens are upset or ashamed about their bodies, with 35% of teenagers worrying about their body image every day.

Emotional distress

Social issues and issues with self-esteem can quickly lead to emotional distress and the development of mental health disorders. Self-esteem issues have been linked to emotional problems (like symptoms of anxiety and depression) as well as problems with attention, which carry with them their own downsides.²

Those with telecanthus may also find themselves having feelings of shame and embarrassment in social situations due to their appearance, which can be exacerbated by questions about their condition from curious strangers. 

Quality of life impact

Telecanthus is a condition that is often present with specific genetic disorders like, for example:

• Down’s syndrome
• Ehlers-Danlos syndrome 
• Foetal alcohol syndrome
• Dubowitz syndrome

As telecanthus is usually present with other disorders, quality of life heavily depends on the comorbid disorder. For example, for those who have acquired telecanthus due to a facial injury, quality of life may be swayed more by societal perception and self-image. For those with more severe genetic conditions that affect cognitive function, quality of life is more heavily impacted by broader developmental and medical challenges faced. 

Social consequences

In this section, we will explore the possible social consequences of living with telecanthus. 

Interpersonal challenges

Having a visible difference puts affected individuals at a higher risk of bullying. This may take the form of excessive, regular and purposeful:

• Teasing 
• Mean actions
• Staring 
• Asking uncomfortable questions 

Bullying affects mostly children and adolescents, typically in school environments. Research has shown that, in cases of bullying that involve personal characteristics, just under a third of students report being bullied for their appearance. Furthermore, students with disabilities tend to be at higher risk of bullying. 

In adults, previous bullying, persistent self-esteem issues or fear of judgment can lead to social isolation. This can further feed into self-consciousness, further impacting mental health. 

Professional and educational impact

In both children and adults, self-esteem plays a major role in education and professional life.³ Negative self-perception may influence academic performance and engagement, career choices and interactions with peers, leading the affected individual down a path they may not necessarily want. 

Coping mechanisms and psychological support

This section will focus on coping mechanisms and psychological support for those affected by telecanthus. 

Adaptation strategies

The road to self-acceptance is not straightforward and may require a lot of time and mental effort. Things that can help to improve self-esteem and build confidence include:

• Focusing on what you’re good at
  • This can help to improve overall mood and confidence
• Building a strong support network
  • Having positive influences around has a positive impact on an individual
  • Meeting others with similar experiences can help one feel less alone 
• Giving yourself grace when you feel self-critical 
• Challenging your perceptions and opinions about yourself 
• Stepping outside of your comfort zone
  • Setting and achieving goals can improve self-esteem 

In more severe cases, a professional can aid in boosting psychological health and self-confidence through talking therapies like counselling or cognitive behavioural therapy. 

How to best support someone with telecanthus 

If you are wondering how you can best support someone with telecanthus who is struggling with their mental health or self-esteem due to their condition, below are some tips on how to show support:

• Involve the affected individual in various events, such as parties and activities, to prevent social isolation 
• Motivate and encourage them – This may help with overall self-esteem 
• Listen to them – Give them the space to express their feelings free of judgement and listen to them when they talk about their struggles 
• Do not excessively stare at individuals with telecanthus in public 
• Avoid any assumptions – Including the assumption that they are struggling with their self-esteem due to their condition. Assuming that can promote the stigma that they “should” be ashamed of their appearance 
• Do not ask excessive questions about their condition – Not everyone is comfortable answering these questions 

Medical and surgical interventions

There is usually no need to surgically treat telecanthus that doesn’t greatly affect vision or self-esteem. With this being said, if telecanthus causes severe psychological distress, surgery to make it less noticeable may be recommended by a clinician. The main surgeries for telecanthus are:

• Tendon shortening and fixation – This option is usually used in genetic or congenital cases of telecanthus 
• Transnasal wiring – This surgical option is usually used in cases where the telecanthus was caused by trauma or an injury  

Summary

Telecanthus, a condition where the inner corners of the eyes are set wider apart than usual, is a generally benign condition, but can have significant psychosocial effects. While it does not usually impact vision or physical health on its own, it can lead to self-consciousness, low self-esteem and emotional distress, particularly in adolescents. Individuals with telecanthus may face social challenges like bullying and isolation, which can further impact their mental health as well as their education and professional life. The condition is often associated with genetic disorders, meaning its impact on quality of life varies depending on the presence of other medical conditions. Coping strategies, psychological support and, in some cases, surgical intervention, can help affected individuals navigate these challenges. By fostering understanding and providing support, society can help to reduce stigma and improve the well-being of those with telecanthus.