Irreversible unilateral visual loss due to acute sinusitis.

Extension of sphenoethmoiditis into the orbital apex may result in visual loss and ophthalmoplegia, but minimal signs of orbital pathology such as proptosis, chemosis, or lid edema. This entity is termed orbital apex syndrome. The case of a 74-year-old woman with orbital apex syndrome and irreversible unilateral visual loss secondary to bacterial sphenoethmoiditis is presented. This case, and our review of the literature, suggest that patients with symptomatic acute sphenoethmoiditis are at a relatively higher risk of permanent visual loss than those with sinusitis not involving the posterior ethmoid and/or sphenoid sinuses.