Delayed Sudden Blindness From Unilateral Ophthalmic Artery Vasospasm Following Endoscopic Sinus Surgery?

Endoscopic sinus surgery (ESS) is a generally benign, minimally invasive procedure used for management of paranasal sinus diseases, although complications may occur due to proximity of vital structures such as the brain, orbit and great vessels.1 The overall ESS major complication rate is 0.5-1%, of which orbital injury accounts for 0.09% due to direct trauma.2 We report a case of unilateral delayed sudden visual loss without orbital trauma observed intraoperatively or on postoperative imaging studies, following a seemingly routine endoscopic sinus surgery for chronic rhinosinusitis.