Baltimore Washington Eye Center, Maryland

Thursday, December 1, 2011

Sinus Problems and Vision Loss

We had an interesting case present to the eye clinic at Baltimore Washington Eye Center recently. The case involved a patient complaining of a blurred area in the vision of their right eye. The visual acuity was normal. However, while the patient did not complain of bulging eyes, upon exam it was clear that the right eye was protruding compared to the left eye. Furthermore, the right optic nerve was swollen.  The diagnosis was made following an MRI of the head and orbits. The patient’s condition turned out to be the result of sinus condition called a mucocele.
Mucoceles are cyst-like, expanding masses found in the sinus cavities.  Mucoceles are most commonly found in the frontal sinus, with the ethmoid and sphenoid sinuses involved less frequently.  The most common causes of mucoceles are chronic infection, allergic rhinitis, trauma, and previous surgery. Depending upon its location, a mucocele can cause a variety of symptoms including orbital pain, decreased visual acuity, visual field defects, exophthalmos (bulging eye), and problems with eye movement. Fortunately, mucoceles affecting the eye(s) are rare and when they do occur, endoscopic sinus surgery is an effective treatment for sinus mucoceles with a favorable long-term outcome. Our patient was referred to an Ear, Nose, and Throat specialist for surgical treatment. Here are several articles furthers detailing sinus mucoceles and the eye.