1. Objective
- To apply targeted mechanical stimulation to the bony orbit to promote bone remodeling, resulting in improved eye shape (widening, lowering, and correction of negative to neutral or slightly positive canthal tilt) and enhanced facial aesthetics.
2. Scientific Basis
- Wolff’s Law: Bone adapts to mechanical stress by remodeling.
- Mechanotransduction: Osteoblasts and osteoclasts respond to applied pressure and tension.
- Frequency & Duration: Regular, short intervals of mechanical load are more effective for remodeling than prolonged static pressure.
3. Exercise Parameters
Parameter Recommendation Rationale Pressure Intensity Moderate to high but tolerable Sufficient stimulus without tissue damage Duration per session 2–5 minutes Optimal duration for bone stimulation without fatigue Frequency Every 30 minutes during waking hours Frequent stimulus maximizes remodeling response Total daily duration 1–2 hours (spread out) Allows recovery and optimal effect Technique Gentle, controlled pulling or pressing on the bony orbital rim Prevents soft tissue injury and ensures targeted mechanical load 4. Procedure
Preparation
- Wash hands thoroughly.
- Optionally, use a soft cloth or finger padding to protect skin.
- Patient should be seated comfortably with an upright posture.
Exercise Steps
- Place thumb or index finger gently on the orbital rim (below the eye at the bony edge).
- Apply controlled, firm but non-painful pulling or pressure.
- Maintain the force steadily for 2–5 minutes.
- Gradually release the pressure.
- Repeat every 30 minutes during the day.
5. Safety Precautions
- Stop immediately if pain, numbness, or swelling occurs.
- Avoid exercises if there is any active infection or injury.
- Maintain strict hygiene to prevent infections.
- Inspect skin and soft tissue weekly for any adverse reactions.
- Ideally, perform under medical or dental supervision.
6. Monitoring and Documentation
- Keep a daily log of exercise times, durations, force levels, and patient feedback.
- Take weekly standardized photos (frontal and lateral) to track changes.
- Optional: Use 3D scanning or radiographic imaging before and after the treatment for objective evaluation.
- Regularly assess ocular function and eye mobility.
7. Expected Results and Timeline
- Subtle changes may appear within 4–6 weeks.
- Significant improvements typically seen after 3–4 months of consistent practice.
- Long-term stability enhanced with concurrent myofunctional therapy and good patient compliance.
8. Complementary Measures
- Incorporate myofunctional therapy to support surrounding musculature.
- Promote nasal breathing to positively influence overall facial development.
- Postural exercises for head and neck alignment.
Additional Note on Pressure Application
Patients should apply very firm, focused pressure for approximately 10 seconds at a time, followed by a brief release, repeatedly throughout each 2–5 minute session. This intermittent high-intensity loading may enhance mechanotransduction and bone remodeling effectiveness.
