A sinus infection occurs when the tissue lining the sinus cavities becomes inflamed and swollen. Sinuses are air-filled spaces within the facial and skull bones. There are four main pairs of sinuses: the maxillary sinuses beneath the eyes, the frontal sinuses above the eyes, the ethmoid sinuses positioned between the eyes, and the sphenoid sinuses located deeper behind the eyes. This close anatomical relationship can lead to eye symptoms.
How Sinus Infections Impact the Eyes
The close proximity of the sinuses to the orbital cavity allows inflammation and pressure from a sinus infection to affect the eyes. When the sinus linings swell, they produce excess mucus, blocking them and causing pressure that radiates to surrounding areas. This pressure causes discomfort or pain around and behind the eyes, sometimes mistaken for a headache.
Sinus infections can also cause watery eyes. This can result from inflammation or obstruction of the tear ducts. Swelling around the eyes, including puffiness of the eyelids, is also common, due to fluid retention and inflammation in adjacent sinus areas. Temporary blurred vision or sensitivity to light may also occur, linked to the pressure, inflammation, or headaches.
Serious Eye Complications from Sinus Infections
While most eye symptoms are minor, some complications can be serious and require immediate medical attention. Orbital cellulitis is a condition where the infection spreads into the soft tissues of the eye socket. Symptoms include redness and swelling of the eyelids and surrounding tissues, pain with eye movements, reduced ability to move the eye, a bulging appearance of the eye, and decreased visual clarity.
Another severe complication is a subperiosteal abscess, a pus collection that forms between the bone and its covering membrane, often from ethmoid or frontal sinus infections. It causes similar symptoms to orbital cellulitis, including a bulging eye, eyelid swelling, pain, and restricted eye movement. Although rare, cavernous sinus thrombosis is a life-threatening complication, a blood clot in the cavernous sinuses, located behind the eyes. This can cause a severe headache, around or behind the eyes, bulging of one or both eyes, double vision, inability to move the eyes, and a high fever. These severe conditions are medical emergencies.
When to Seek Medical Attention
Recognizing when eye symptoms related to a sinus infection warrant medical evaluation is important. You should seek prompt medical attention if your sinus symptoms, including eye involvement, persist longer than 7 to 10 days or worsen after initial improvement.
Specific “red flag” symptoms that indicate a serious complication include any sudden changes in vision, such as vision loss, double vision, or blurring. A bulging eye, inability or difficulty moving the eye, or severe and worsening eye pain are also concerning signs. A persistent high fever, especially above 103°F or lasting more than three days, along with a severe headache, confusion, or a stiff neck, also require immediate medical assessment.
Diagnosis and Management
Diagnosing a sinus infection with eye involvement begins with a physical examination and a review of your symptoms. To determine the extent of the infection and its impact on the eyes, medical professionals use imaging tests, such as a computed tomography (CT) scan of the sinuses and orbits. An ophthalmologist may also be consulted to assess eye health and rule out other conditions.
Management focuses on treating the underlying sinus infection. For bacterial infections, antibiotics are prescribed, particularly if symptoms are severe or do not improve within ten days. Nasal corticosteroids can help reduce inflammation and improve sinus drainage, while decongestants may provide temporary relief from swelling. Saline nasal rinses are also recommended to help clear nasal passages.
In severe cases, such as the presence of an abscess, intravenous antibiotics may be administered, and surgical intervention might be necessary to drain the infection. It is important to rely on professional medical diagnosis and not attempt to self-treat severe eye symptoms.