Dangerous eye complications due to sinusitis

Sinusitis seems simple but can directly attack the eyes, causing blindness if treatment is delayed. With 85% of sinus complications related to the eyes, early recognition of abnormal signs is a vital factor, especially in young children.

Sinusitis is one of the most common diseases today. Although it is not a life-threatening disease, its symptoms and complications have a great impact on health and daily life. In which, eye complications account for up to 85% of cases, which can threaten long-term vision if not treated properly.

Common eye complications due to sinusitis

Sinusitis patients, if not treated well and thoroughly, are susceptible to eye complications, including:

• Periorbital connective tissue inflammation: Often occurs in patients with acute sinusitis, causing severe eye pain, swollen eyelids, pain spreading to the top of the head and temple area.
• Optic neuritis: Causes sudden loss of vision, funduscopy cannot find the cause.
• Lacrimal sac abscess: Acute sinusitis can lead to lacrimal sac abscess with symptoms of swelling of the inner corner of the eye, redness spreading to the eyelid and conjunctiva, fever, eye pain, and can form a chronic fistula.
• Eyelid abscess: Frontal sinusitis or ethmoid sinusitis can cause eyelid abscesses, causing the eyelids to swell, become red, hot, painful, and have conjunctival congestion. The abscess can rupture after 4-5 days, causing pain and affecting vision. Regardless of the level of complications, people with sinusitis need to go to a medical facility early for timely diagnosis and treatment to protect their eye health and vision.

Level of sinusitis complications in the eyes

• Grade I – Preseptal cellulitis: Swollen eyelids, no protrusion → antibiotic treatment.
• Grade II – Post-septal cellulitis: Limited eye movement, no outbreak → close monitoring.
• Grade III – Subperiosteal abscess: Fluid collection along the medial wall of the orbit → surgery is required if treatment is not responsive.
• Grade IV – Orbital abscess: Severe eye protrusion, decreased vision → emergency surgery.
• Grade V – Cavernous sinusitis: Bilateral damage, ophthalmoplegia → requires intensive resuscitation.

Sinusitis is one of the most common diseases today.

Recognize sinusitis eye complications

Symptoms vary depending on the location of the damage in the eye or optic nerve. Common signs include:

• Itchy eyes, pain when moving vision, difficulty moving eyes.
• Red and swollen eyelids with yellow or green discharge.
• Sudden loss of vision, blurred vision.
• Fever, fatigue, headache, loss of appetite.

To accurately determine the complication, the ophthalmologist will:

• Watch for unusual signs such as pain, redness, swelling, and fever.
• Tests to check for infection.
• Analyze secretions or blood to look for disease-causing bacteria.
• MRI and CT scans to assess the extent of infection and related complications.

Diagnosis of sinusitis with eye complications should be made early to avoid lasting damage to vision.

Summary: Orbital complications are the most common extra-sinus complications in children, especially in acute purulent ethmoid sinusitis. The disease can progress from cellulitis to abscess in just 24 - 48 hours. If not detected early, children are at risk of losing their vision and even life-threatening.

Therefore, when a child has swelling around the eyes accompanied by a high fever, it is necessary to take them to an ENT and Ophthalmologist immediately. Early detection, multidisciplinary consultation and timely surgery are the keys to preserving the child's vision.

A typical case is a 5-year-old patient admitted to the hospital with high fever, red and swollen left eyelid, unable to open eye. At 108 Military Central Hospital, tests showed white blood cells 21 G/L, CRP 109 mg/L, PCT 0.49 ng/mL - suggesting severe acute infection. MRI images detected fluid around the inner wall of the left eye socket, retrobulbar fat edema, suggesting acute purulent ethmoid sinusitis with orbital complications - subperiosteal abscess (Chandler III). The patient was treated with broad-spectrum intravenous antibiotics, but the swelling increased rapidly, and the eye protruded more clearly. After a multidisciplinary consultation of ENT - Ophthalmology - Pediatrics - Anesthesia and Resuscitation, the child underwent emergency endoscopic surgery to drain the ethmoid sinus and abscess, removing a lot of thick, yellow pus. After surgery, the child's swelling significantly reduced, he was able to open his eyes, and his vision was preserved.

Source: https://suckhoedoisong.vn/bien-chung-nguy-hiem-o-mat-do-viem-xoang-1692512022028559.htm