Bilateral Blindness Due to Acute Isolated Sphenoid Sinusitis- Is It Reversible? A Case Report

Naresh K Panda,Roshan Kumar Verma

doi:10.3329/jom.v15i2.20700

Abstract

Acute isolated sphenoid sinusitis is a rare and is seen in only 3% of all cases of all sinusitis. It is frequently misdiagnosed because of its vague clinical presentation. We report a case of 35year old female who presented to our emergency department with complaints of painless rapidly developing bilateral vision loss. Non contrast computed tomography of paranasal sinuses showed only mild opacification of sphenoid sinus. Endoscopic sphenoidectomy was performed within 4 hrs of presentation. After 48 hrs of surgery the patient vision returned to 6/6 bilaterally. Acute sphenoid sinusitis should be considered in the differential diagnosis of acute vision loss. Awareness, early diagnosis, astute clinical sense and emergent intervention can prevent permanent complication.DOI: http://dx.doi.org/10.3329/jom.v15i2.20700 J MEDICINE 2014; 15 : 146-148

Highlights

Visual loss has been known to complicate bacterial sinusitis.[1]
Spread of infection into orbital tissue is more common from ethmoid sinus due to its thin walls and to openings which communicate with the orbit and is usually assosciated with signs of orbital inflammation i.e. orbital pain, lid edema, orbital cellulitis, opthalmoplegia
Isolated acute sphenoid sinusitis could lead to bilateral acute vision loss

Summary

Introduction

Visual loss has been known to complicate bacterial sinusitis.[1]. It could be either due to direct spread of infection and inflammation or may be secondary to pressure on the exposed optic nerve.[2]. We report a case of 35-year-old female who presented to us with rapidly progressive bilateral vision loss with headache. Emergency sphenoidotomy done resulted in reversal of vision loss bilaterally This case is being presented to increase awareness among otolaryngologist about this condition develop high index of suspicion to prevent permanent complications due to sphenoid sinusitis. Case Report: A 35-year- old female presented to our Emergency department with complaints of rapidly progressing, painless, bilateral vision loss of vision. She initially complained of blurring of vision on right side for five days which progressed to complete loss of vision at time of presentation and history of blurring of vision on the left eye for 1 day. She is on regular follow up and is asymptomatic at present

Discussion

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Conclusion