Walsh & Hoyt: Sinusitis

Infection of the paranasal sinuses by bacteria or other organisms may produce neuro-ophthalmologic symptoms and signs by extension of the process into the adjacent orbit, intracranial cavity, or both. Acute, bacterial sinusitis may produce meningitis, brain abscess, epidural or subdural empyema, orbital cellulitis, and septic thrombosis of one or more intracranial dural venous sinuses, most commonly the cavernous and superior sagittal sinuses. Patients with sinusitis may develop diplopia from damage to one or more of the ocular motor nerves or the muscles they innervate. Progressive unilateral or bilateral visual loss may result from inflammation of the optic nerves, compression by an associated orbital or subperiosteal abscess or hematoma, or vascular compromise.