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Sphenoidal sinus mucocoele presenting as mono-ocular painless loss of vision

¹ Lokmanya Tilak Medical College and General Hospital, Mumbai, India
² LTMG Hospital, Sion, Mumbai, India; drandy2003@yahoo.co.in
³ Lokmanya Tilak Medical College and General Hospital, Mumbai, India
⁴ LTMG Hospital, Sion, Mumbai, India

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A 22 year old man presented with acute onset of loss of vision in the right eye of six hours’ duration. There were no associated complaints of pain or redness of eye. There was no associated convulsion or alteration in sensorium. He complained of a mild headache over the past two days. On examination the perception of light in the right eye was absent. Light and accommodation reflex testing revealed a right afferent abnormality. Funduscopy showed blurred disc margins and pallor of the right optic disc. Eye movements were normal and painless. There was no other focal neurological deficit.

A computed tomogram of the brain and paranasal sinus (fig 1) revealed a large mucocoele in the right sphenoidal sinus, with a defect in the lateral wall of the sinus. Optic nerve imaging with gadolinium enhanced magnetic resonance imaging (MRI, fig 2) confirmed the findings and did not reveal . . . [Full text of this article]