Neuro-ophthalmic complications of endoscopic sinus surgery.

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.