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Orbital apex syndrome due to sinus infection

Orbital extension of acute paranasal sinus infection seems to be an occurrence of increasing frequency and increasing severity in the past few years. This recurrence of an old phenomenon is happening despite medical specialization, due to alteration of bacteria biology due to generation‐long use of antibiotics. Alteration of host responses due to use of steroids is also responsible. Over‐reliance on diagnostic aids alters clinical judgment. Especially important is the fact that, in the most serious complication, cavernous sinus thrombophlebitis, one can be misled by fundoscopic examination, inasmuch as the state of the disk is not a reliable index.