2025 Volume 118 Issue 12 Pages 873-877
Nasal intraorbital complications refer to conditions in which inflammation extends from the nasal sinuses to the orbit, potentially causing visual defects. Left untreated long, these visual defects could result in irreversible visual impairment. Therefore, early diagnosis and treatment are important.
In this report, we describe two cases of nasal intraorbital complications that were diagnosed and treated at an early stage and showed a good visual prognosis.
Case 1: A 79-year-old woman visited an ophthalmology clinic with the chief complaint of left eyelid swelling. Five days later, she reported a decrease in visual acuity on the left side and was referred to our department as the findings of CT and MRI led to the suspicion of nasal intraorbital complications secondary to acute sinusitis. We performed endoscopic rhinosinus surgery and extra-nasal drainage on day 2 after the patient reported visual impairment, in an attempt to restore the visual acuity. The patient’s visual acuity improved postoperatively. Case 2: A 60-year-old woman presented to our department with right upper eyelid swelling that had developed a few days after she suffered from an upper respiratory infection. We performed endoscopic rhinosinus surgery and drainage through an external nasal incision. Her visual function was preserved postoperatively.
Early treatment is important in patients presenting with nasal intraorbital complications. Many articles have reported that visual impairment due to naso-orbital complications may fail to resolve if not treated within 48 hours. Case 1 suggests that ophthalmologists should consider the possibility of nasal intraorbital complications in patients presenting with vision problems after an upper respiratory infection. Fortunately, the patient was treated within 48 hours and her vision improved. Case 2 could be treated before the onset of vision loss. Early treatment was considered important to preserve vision.
