Ophthalmic manifestations of allergic fungal sinusitis

Abstract

Background: Orbital complications of allergic fungal rhinosinusitis (AFRS) are uncommon but can result in significant morbidity if inappropriately managed.Objective: To evaluate the clinical presentation, diagnosis, management, and outcome of orbital complications of AFRS.Methods: Retrospective chart review of 200 cases diagnosed with AFRS.Results: Thirty-two patients had orbital complications of which the most common ophthalmic presentation was proptosis (83%), followed by epiphora (33%), ophthalmoplegia (33%), diplopia (22%), visual loss (13%), and subperiosteal abscess (6%). CT sinus scans showed that 62% of patients had erosion of the lamina papyracea, 24% had intraorbital extension of the disease associated with skull base erosion, 16% presented with bilateral erosion of lamina papyracea, 50% presented with bilateral pansinusitis, and 61% had right-sided predominance.Conclusion: Although orbital complications of AFRS are uncommon, they can be serious and necessitate immediate surgical intervention. Ophthalmologists and otorhinolaryngologists should be familiar with these complications.