title: Sphenoidal sinus mucocele presenting with acute visual loss in a scuba diver.
abstract: A 43-year-old male scuba diver presented with an acute history of painful unilateral visual loss after scuba diving. He had right-sided retrobulbar pain and headache. He was known to have sinusitis and had transient visual loss in two previous episodes after scuba diving. His visual acuity was hand motions and 20/20 in the right and left eye, respectively. There was no proptosis. He had a right relative afferent pupillary defect. Colour vision was normal in the left eye and absent in the right eye. Fundal examination revealed healthy discs and macula bilaterally. He was assessed as a right optic neuropathy, possibly secondary to compression. An MRI of the brain revealed a large sphenoidal mucocele extending into the right optic foramen. He was treated with oral steroids, antibiotics and nasal decongestants. He underwent endoscopic intranasal sphenoidectomy and marsupialisation with return of his visual acuity to 20/25 in that eye.
authors: University of the West Indies, Kingston, Jamaica. lizettemowatt@yahoo.com
authors: Lizette
authors: L
authors: Mowatt
authors: Tecah
authors: T
authors: Foster
mesh_terms: D000328:Adult; D001469:Barotrauma / Q000150:complications*; D003664:Decompression; D004242:Diving; D058447:Eye Pain / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009078:Mucocele / Q000150:complications*; D009408:Nerve Compression Syndromes / Q000209:etiology*; D009901:Optic Nerve Diseases / Q000209:etiology; D010254:Paranasal Sinus Diseases / Q000150:complications*; D013101:Sphenoid Sinus; D014786:Vision Disorders / Q000209:etiology*; D058609:Visual Field Tests
references: Arch Otolaryngol Head Neck Surg. 1992 Feb;118(2):142-6
references: 1540343
references: B-ENT. 2005;1(4):181-5
references: 16429750
references: Br J Ophthalmol. 1998 Jan;82(1):99-100
references: 9536894
references: Jpn J Ophthalmol. 2005 May-Jun;49(3):239-45
references: 15944832
references: Pediatr Radiol. 2006 Sep;36(9):987-90
references: 16802142
references: Am J Rhinol Allergy. 2011 Jul-Aug;25(4):272-5
references: 21819766
references: Indian J Ophthalmol. 2012 May-Jun;60(3):216-8
references: 22569385
references: J Natl Med Assoc. 2006 Jan;98(1):63-6
references: 16532980
references: Br J Neurosurg. 1998 Dec;12(6):527-30
references: 10070461
references: J Laryngol Otol. 2010 Jan;124(1):44-7
references: 19825255
references: BMJ Case Rep. 2012 Oct 22;2012:
references: 23093506
references: Can J Ophthalmol. 2005 Aug;40(4):506-8
references: 16116519
references: Am J Rhinol. 1997 Sep-Oct;11(5):337-43
references: 9768314
references: J Craniofac Surg. 2008 Sep;19(5):1381-4
references: 18812867