A Rare Presentation of Occult Sinusitis: Upper Eyelid Fistula.

Sinus disease can present in a variety of ways and may occur in individuals who are not otherwise aware that they have problems (occult sinusitis). An unusual presentation of occult frontal sinus disease in a 64-year-old patient was reported. A fistulous communication with the upper lid, causing a persistent abscess. There was a 6-month delay in making the correct diagnosis and the patient was treated with repeated courses of antibiotics and even an incision and drainage procedure. Finally, the correct diagnosis was made following CT imaging and the patient underwent functional endoscopic sinus surgery which closed the communication, but left the patient with a tight upper lid, which required further oculoplastic surgery. The patient was pleased with the final visual outcome and the fistula remained closed.