Complications of vision loss and ophthalmoplegia during endoscopic sinus surgery

mplications of vision loss and ophthalmoplegia during endoscopic sinus surgery Case report (292) Total Article Views Authors: Maharshak I, Hoang JK, Bhatti MT Published Date March 2013 Volume 2013:7 Pages 573 - 580 DOI: http://dx.doi.org/10.2147/OPTH.S40061 Received: 07 November 2012 Accepted: 17 December 2012 Published: 20 March 2013 Idit Maharshak,1,2 Jenny K Hoang,3 M Tariq Bhatti2,4 1Department of Ophthalmology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; 2Department of Ophthalmology, 3Department of Radiology (Division of Neuroradiology), 4Department of Medicine (Division of Neurology), Duke Eye Center and Duke University Medical Center, Durham, NC, USA Objective: To describe two rare cases of concurrent vision loss and external ophthalmoplegia following powered endoscopic sinus surgery (ESS). Design: Observational case report. Results: The records of two patients who underwent powered ESS and developed multiple concurrent ophthalmic complications were retrospectively reviewed for clinical history, neuro-ophthalmologic examination, and imaging findings. Patient 1 developed a retinal vascular occlusion and complete loss of adduction. Patient 2 developed an orbital hemorrhage, optic neuropathy, and a restrictive global ophthalmoplegia. Similar published case reports were also reviewed. Conclusion: Despite advances in powered ESS technique and instrumentation, serious ophthalmic complications can still occur. Inadvertent entry into the medial orbital wall can result in a combination of blindness and ocular motility dysfunction. The variety of mechanisms responsible for these complications underscores the importance of thorough pre- and postoperative clinical examination and review of imaging studies.