Asymptomatic posterior orbital cellulitis resulting from ethmoid/maxillary sinusitis

Although vision-threatening sinusitis complications are not uncommon, an unusual case of asymptomatic posterior orbital cellulitis resulting from maxillary and ethmoidal sinus infection is presented.

An 11-year-old girl was brought to us for a routine optometric examination, reporting only blurred distance vision. A mild afferent pupillary defect was the key to detection and diagnosis of a vision-threatening posterior orbital cellulitis.

A literature review of relevant anatomic and pathologic mechanisms, as well as radiologic recommendations, follows. This case appears to be a new clinical entity, an asymptomatic variant of posterior orbital cellulitis.