Visual loss associated with orbital and sinus diseases.

Visual loss associated with orbital and sinuses diseases is mainly due to infectious processes, trauma and neoplasm. From 1975 to 1983, we have encountered 34 such cases. The most common cause in our series was infectious processes, either due to aerobic or anaerobic bacteria or fungi (aspergillosis and phycomycosis). Iatrogenic trauma resulting in complete unilateral irreversible blindness was the second most common etiology in the series of cases that came to our attention for several reasons. Three of our patients with complete blindness, even with documented absence of light perception, secondary to infections or mucocele, underwent emergency surgical treatment with successful restoration of vision. Other patients with various degrees of visual loss experienced improvement, often to normal levels, when timely appropriate surgical treatment was applied. Orbital or optic nerve decompression was used according to pathologic findings encountered. High resolution CT scan has been very helpful in precisely pinpointing the lesion. It is also indispensable in the follow-up of orbital abscesses in order to rule out intracranial complications. Blindness with immediate onset secondary to either external or iatrogenic trauma, with rare exceptions, has a dismal prognosis. Early diagnosis and prompt treatment are essential for salvage of vision or even lives of patients affected by such dreadful complications.