Widening of the orbital distance manifests as a significant widening of the distance between the two eyes. Medically, this is called orbital spacing widening. It is a condition in which the bony distance between the two orbits is excessively widened. It may be associated with craniofacial clefting, flattening of the nasal bridge, lacrimation, subcutaneous tissue hyperplasia, cerebrospinal bulge, and craniofacial deformity. It is a congenital developmental malformation. I. Diagnostic criteria: Bony orbital spacing varies according to race, age and gender. The orbital spacing is wider in oriental than in westerners. Diagnostic criteria for oriental people:1. Mild: 30-34mm; 2. Moderate: 35-39mm; 3. Severe: 40mm and above. Surgery is currently the only treatment method. Generally speaking, surgery is best performed at the age of 5-6 years. It helps the psychological improvement of preschool children. surgery can be performed at any age after 5-6 years old. II. Detailed preoperative preparation after hospitalization procedures, including: 1. Clinical examination: Examination and description of the extent and characteristics of deformities in the orbital, frontal and nasal regions and of other facial abnormalities. Measurement of the internal orbital distance, internal canthal distance, and pupillary spacing. Examine visual acuity, reflex to light, eye movements and fundus, noting the presence of strabismus. Pay attention to the situation in the nasal cavity, the presence of nasal septum deviation, the presence of cerebral (membrane) bulge, and whether the sense of smell is normal, etc. 2.Imaging examination: Before surgery, take anterior-posterior cranial X-ray film routinely, and do 3D CT and MRI examination to obtain accurate information about the thickness, length, angle and degree of displacement of periorbital bones, measure the distance between the optic nerve foramina on both sides, and pay attention to the frontal sinus and septal sinus situation and whether there is prolapse of sieve plate. 3.Other: Preoperatively, the patient’s liver, kidney, cardiopulmonary function and blood biochemistry and other related examinations should be completed to estimate whether the patient can tolerate a longer surgery under general anesthesia. Start antibiotic drops 3 d before surgery, and 1 d before surgery static antibiotics to inhibit anaerobic bacteria in the frontal sinus and paranasal sinus. Prepare blood 1500-2000mL. Before surgery, the surgeon will communicate and discuss with the child’s parents in detail about the child’s current condition, the procedure, the risks and potential complications, and obtain the consent of the child’s parents. The surgical approach is divided according to the degree of widening of the orbital distance: 1) outer cranial approach: for mild widening of the orbital distance, only the outer cranial approach is required; 2) combined intracranial-external approach: for severe widening of the orbital distance, there is true lateral ectasia in both orbits and the patient has visual impairment, the combined intracranial-external orbital approach must be used. A combined intracranial-extracranial orbital osteotomy or midfacial split is necessary for severe orbital widening. The surgery is performed in a hospital operating room. General anesthesia is used. The child is asleep during the entire operation. Postoperatively, the child’s vital signs, including respiration, pulse, blood pressure and intracranial pressure, were closely monitored. The focus was on the state of consciousness, bilateral pupil changes, and limb movements. Broad-spectrum antibiotics were routinely given intravenously for about seven days. The stitches are removed 7-10 days after surgery. Any abnormalities will be dealt with at any time. Fourth, surgical complications: including intraoperative bleeding, postoperative infection, intracranial hypertension, ophthalmic complications, lacrimal sac nasolacrimal duct injury, cerebral edema, subdural hematoma, cerebrospinal fluid leakage, etc. After 7-10 days of postoperative observation, surgical dressing changes and nursing care, the child can be discharged from the hospital. If there are complications, the duration of postoperative hospitalization should be extended appropriately, and the child should be reviewed upon request after discharge so that the child’s condition can be evaluated. As the child grows and develops, new deformities may appear or require reoperation, so it is necessary to contact the plastic surgeon again.