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Fungal pan-sinusitis with severe visual loss in uncontrolled diabetes
Jocelyn L L Chua1, James F Cullen
1Singapore National Eye Centre, Singapore. jocelynchua77@yahoo.com
Introduction:
Invasive fungal pan-sinusitis can present atypically with severe acute visual loss with minimal anterior orbital inflammation. We describe 2 such cases with a background of uncontrolled diabetes.
Clinical Picture:
Respective clinical presentations of orbital apex and cavernous sinus syndromes were associated with isolation of Aspergillus galactomannan and Rhizopus.
Treatment:
Urgent extensive surgical debridement and systemic antifungal is necessary.
Outcome:
Clinical improvement of the ocular motor nerves can be expected within 2 months of treatment but visual loss is usually permanent.
Conclusion:
Underlying pansinusitis is an important differential for acute visual loss, especially in uncontrolled diabetics. Early treatment determines outcome.
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