Allergic fungal rhinosinusitis causing blindness

This is an interesting case report involving a patient with allergic fungal sinusitis causing blindness.

History:

60 year's old male patient reported to the outpatient department with C/O blindness & inability to open left eye - 1 week.
He is a known diabetic on irregular treatment.

He also gave history of bleeding from left nose on and off - 3 months duration associated with nasal block on that side.

On examination:

Ptosis of left eye +
Proptosis of left eye +
Left eye was fixed without movement +
Pupillary reflex absent on the right side

Nose:

Polypoidal mass seen occupying the whole of the nasal cavity

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clinical photograph of the patient

Axial CT scan plain showed heterodense lesion occupying the left nasal cavity. The mass could be seen eroding the
lamina papyracea to involve the orbit.

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Axial CT of the patient

MRI study showed soft tissue mass in the left nasal cavity involving the left optic nerve

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MRI of the patient

Patient was taken up for endoscopic sinus surgery

Video clipping of the surgical procedure

Surgical clipping

Histopathology showed mucor mycosis

This case is being reported in order to high light the dangers of allergic fungal sinusitis.

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