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Neuro-ophthalmic complications of endoscopic sinus surgery

Bhatti, M Tariq

Current Opinion in Ophthalmology: November 2007 - Volume 18 - Issue 6 - p 450–458
doi: 10.1097/ICU.0b013e3282f0b47e
Neuro-ophthalmology: Edited by Robert C. Sergott

Purpose of review This review aims to provide an overview of powered endoscopic sinus surgery and raise awareness of the possible neuro-ophthalmic complications associated with the procedure.

Recent findings The neuro-ophthalmic complications of endoscopic sinus surgery can be categorized into five anatomic sites: eye, orbit, optic nerve, extraocular muscle, and lacrimal drainage system. Double vision may be caused by various ocular motility abnormalities. Visual loss may be the result of orbital hemorrhage or direct optic nerve trauma.

Summary A wide range of neuro-ophthalmic complications may occur during endoscopic sinus surgery. The use of powered cutting instruments has been a recent advance in endoscopic sinus surgery, but it has also been implicated in rapid, irreversible, and devasting complications. Multiple preoperative and intraoperative factors appear to be involved in the adverse events associated with endoscopic sinus surgery. Ophthalmologists may be asked to evaluate and manage ocular damage in patients who have undergone endoscopic sinus surgery, and in some cases emergent intervention may be required in an attempt to avoid permanent visual loss.

Duke University Eye Center, Duke University Medical Center, Durham, North Carolina, USA

Correspondence to M. Tariq Bhatti, MD, Associate Professor, Departments of Ophthalmology and Medicine (Division of Neurology), 2351 Erwin Road, Duke University Eye Center, DUMC 3802, Durham, NC 27710-3802, USA Tel: +919 681 9191; fax: +919 684 0547; e-mail:

© 2007 Lippincott Williams & Wilkins, Inc.