Telecanthus
Page most recently updated 7 September 2026
This page focuses on telecanthus as a morphologic feature of conditions that may also be associated with psychiatric manifestations, such as psychosis, mania, autism spectrum disorder, ADHD, OCD, and self-injurious behaviours. The page begins with a clinical definition of telecanthus based on the standardized Elements of Morphology terminology, together with visual examples from the same source. This is followed by a list of conditions in which telecanthus has been described in association with psychiatric manifestations.
Of note, to optimize clinical utility, the list does not include conditions associated with intellectual disability in the absence of other psychiatric features.
Each condition listed below is linked to a dedicated page within this resource. These pages describe the psychiatric manifestations associated with each condition, as well as other morphologic and broader clinical features, allowing the differential diagnosis to be considered from multiple perspectives.
Telecanthus
Telecanthus without (A) and with (B) widely spaced eyes.
Image credit: National Human Genome Research Institute (NHGRI), Elements of Morphology.
Comparison between widely spaced eyes and telecanthus
Visual comparison of normal eye spacing and inner canthus position with widely spaced eyes (hypertelorism) and telecanthus, These images were artificially manipulated to simulate clinically observed variations.
Image credit: R. Hennekam, M.D.; National Human Genome Research Institute (NHGRI), Elements of Morphology; cropped from original figure.
Definition
Subjective: Apparently increased distance between the inner canthi.
Objective: Distance between the inner canthi more than 2 SD above the mean.
Note: Telecanthus may be present without or with Widely spaced eyes. In the latter case, Widely spaced eyes should be considered separately. Inner canthal distance varies among ethnic groups. Norms are available for American Africans, Chinese and Caucasians. In the presence of an epicanthal fold, ascertainment of inner canthal distance can be difficult.
Synonyms: Dystopia canthorum.
Conditions with potential psychiatric associations
Selected references and further reading — Morphologic lens
Allanson JE, Biesecker LG, Carey JC, Hennekam RCM. Elements of morphology: introduction. Am J Med Genet A. 2009;149A(1):2-5.
Hennekam RCM, Biesecker LG, Allanson JE, Hall JG, Opitz JM, Temple IK, Carey JC; Elements of Morphology Consortium. Elements of morphology: general terms for congenital anomalies. Am J Med Genet A. 2013;161A(11):2726-2733.
Jones KL, Jones MC, del Campo M. Smith's recognizable patterns of human malformation. 8th ed. Philadelphia: Elsevier; 2021.
Reardon W. The bedside dysmorphologist: a guide to identifying and assessing congenital malformations. 2nd ed. Oxford: Oxford University Press; 2016.