DR. JIGNA MOTWANI

Dr.Sachin Daigavane, Dr.Madhumita prasad

Abstract

Introduction-Secondary involvement of orbit in a common paranasal sinus fungal infection, Aspergillosis, is rare. A case of invasive aspergillosis of right maxillary sinus in 30 year old immunocompetent male patient was referred to ophthalmology opd with unilateral proptosis.

Clinical scenario-Patient had proptosis in right eye since 6 months, insidious in onset, progressive, not associated with painful movements. It showed regression since 1 month. On examination, visual acuity was 20/20 in right eye with light projection accurate in all quadrants, normal color vision, pupil was normal in size, reacting to light. Extraocular movements were reduced on lateral side. Left eye was within normal limit.

Diagnosis-Magnetic resonance imaging showed involvement of intra and extraconal compartment upto apex of orbit, pushing optic nerve medially, with erosion of lamina papyrecea.

Management-Intravenous amphotericin B was started. Regular follow up was done to prevent optic nerve involvement.