Ocular Manifestations of Rhino-Sino-Orbital Mucormycosis – A Pilot Study at a Tertiary Healthcare Facility of North India
Abstract
Mucormycosis is the third most common invasive fungal infection following aspergillosis and candidiasis. Sino-nasal mucormycosis, if unrecognized or inadequately treated is an acutely fatal fungal infection. The objective here was to study the ocular manifestations in patients of sinonasal mucormycosis. A total of 40 patients with microbiologically and histopathologically proven, Sinonasal Mucormycosis were analysed over a period of 1 year (January 2018 to December 2018). The emphasis was on subjects with ocular manifestations on presentation. Ocular symptoms had a duration of less than a week in 86.2% of the patients. Periorbital swelling in 70% (with 67.9% having periorbital swelling of left side), and loss of vision in 67.5% were the chief complaints. Total Ophthalmoplegia was noted in 57.5% and central retinal artery occlusion was detected in 50% on fundus examination. Pupillary reflex was absent in 37.5%. Extra-ocular muscle involvement (65%) was the most common finding on ophthalmic examination followed by chemosis (62.5%). A high clinical suspicion is needed for an early diagnosis of mucor as the underlying aetiology, which plays a key role in outcome of the disease. Short duration of ocular symptoms and unilaterality is highly suggestive.
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