Orbital involvement in sinus pathology: often without ocular pain

Many and diverse sinus pathologies can present with an orbital involvement. Contrary to popular belief, uncomplicated rhinosinusitis causes rarely orbital pain or headaches. However, especially in children, acute ethmoidal rhinosinusitis can be complicated by an extension of the infection into the orbit. Also, isolated sphenoid sinusitis is often associated with significant ophthalmologic or neurological complications. Sinus surgery is another possible source of orbital complications associated with pain. The occurrence of orbital pain in these and other sinus pathologies is discussed, since early recognition and prompt therapeutic action are often necessary in order to avoid devastating sequellae.