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Area of Science:

  • Ophthalmology
  • Otorhinolaryngology

Background:

  • Endoscopic sinus surgery (ESS) is a common procedure for sinonasal diseases.
  • Potential complications, though rare, can affect adjacent structures, including the eye.

Observation:

  • A 44-year-old male experienced immediate vision loss in his right eye post-endoscopic ethmoid sinus surgery.
  • Clinical examination revealed proptosis, ecchymosis, exotropia, and impaired adduction.
  • Orbital CT confirmed medial rectus muscle and optic nerve violation.

Findings:

  • Fundus examination showed macular edema, hemorrhages, and subretinal hyperfluorescence.
  • Macular edema, nonperfusion, ischemia, choroidal nonperfusion (Amalric sign), and atrophy were noted.
  • Vision improved to 20/300 with residual macular and peripheral choroidal atrophy after 6 months.

Implications:

  • This case underscores the risk of iatrogenic ocular injury from ESS.
  • Ophthalmologists and ENT surgeons should be aware of these potential vision-threatening complications.
  • Prompt recognition and management are crucial for optimizing visual outcomes after ESS.