A man in his 40s was seen in our emergency department with pain over his left eye for several days. He had a remote history of trauma with skull fracture 14 years previously. External examination showed left hypoglobus and limitation of upgaze, and dilated fundus examination demonstrated choroidal folds in the left eye (Figure, A). B-mode ultrasonography showed a hypoechoic pseudocystic orbital lesion causing globe deformity. Magnetic resonance imaging confirmed the diagnosis of frontal sinus mucocele and revealed intracranial extension with left frontal lobe enhancement representing encephalomalacia (Figure, B). The patient underwent evacuation of the mucocele through a frontal craniotomy approach and had postoperative resolution of hypoglobus and choroidal folds.
Wagner LH, Reich SS, Johnson BB. Frontal Sinus Mucocele Diagnosed by Fundus Examination and B-Mode Ultrasonography. JAMA Ophthalmol. 2015;133(8):e151159. doi:10.1001/jamaophthalmol.2015.1159