Maniglia A J, Kronberg F G, Culbertson W
Laryngoscope. 1984 Aug;94(8):1050-9. doi: 10.1288/00005537-198408000-00012.
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.
与眼眶和鼻窦疾病相关的视力丧失主要归因于感染性病变、外伤和肿瘤。1975年至1983年期间，我们遇到了34例此类病例。在我们的病例系列中，最常见的病因是感染性病变，其由需氧菌、厌氧菌或真菌（曲霉菌病和藻菌病）引起。医源性外伤导致完全性单侧不可逆失明是引起我们注意的病例系列中的第二常见病因，原因有多种。我们的三名完全失明患者，即使记录显示无光感，继发于感染或黏液囊肿，也接受了紧急手术治疗，视力成功恢复。其他有不同程度视力丧失的患者，在及时进行适当的手术治疗后，视力常常改善至正常水平。根据所遇到的病理结果进行眼眶或视神经减压。高分辨率CT扫描对于精确确定病变非常有帮助。在眼眶脓肿的随访中，它对于排除颅内并发症也是必不可少的。由外部或医源性外伤继发的立即失明，除极少数例外，预后很差。早期诊断和及时治疗对于挽救受此类可怕并发症影响的患者的视力甚至生命至关重要。
