Antibiotic responsive exophthalmos and lateral rectus paralysis

Sinusitis is an unusual cause of exophthalmos in adults since the advent of antibiotics. Many periorbital complications of sinusitis have been described; however exophthalmos associated with apparent sixth cranial nerve palsy in the absence of ipsilateral sphenoidal sinusitis is a rare and, to our knowledge, unreported complication of sinusitis. We report such a case that was treated with oral antibiotics. We believe that sinusitis must always be considered in adults as a treatable cause of exophthalmos and various orbital complications from isolated lateral rectus paralysis to acute-onset, acquired Brown's syndrome.