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Transient vertical diplopia and silent sinus disorder
F X Borruat1, B Jaques, J Dürig
1Hôpital Ophtalmique Jules Gonin, Lausanne, Switzerland.
Summary
A man experienced temporary double vision due to a sinus issue affecting his eye socket. Surgical repair of the orbital floor resolved the condition, restoring normal vision.
Area of Science:
- Ophthalmology
- Otolaryngology
- Neurosurgery
Background:
- Recurrent vertical diplopia can be a challenging symptom to diagnose.
- Orbital floor fractures, even subtle ones, may present with atypical symptoms.
Observation:
- A 57-year-old male presented with isolated, transient, recurrent vertical diplopia.
- Physical examination revealed left hypoglobus and enophthalmos.
- Imaging identified asymptomatic left maxillary chronic sinusitis with an 8 mm orbital floor depression.
Findings:
- The patient's transient diplopia was attributed to temporary impairment of binocular fusion.
- The underlying cause was identified as a depressed orbital floor secondary to chronic sinusitis.
Implications:
- This case highlights the importance of considering orbital floor abnormalities in patients with unexplained diplopia.
- Surgical reconstruction of the orbital floor can effectively treat diplopia caused by such defects.
- Multidisciplinary approaches involving ophthalmology and otolaryngology are crucial for managing complex orbital conditions.