Optic Chiasma Involvement Secondary to Allergic Fungal Rhinosinusitis

Optic chiasma compression is a very rare complication of allergic fungal rhino sinusitis. Here we report the rare case of a 35 year-old female suffering from unilateral visual loss presented with allergic fungal sinusitis with sphenoid sinus involvement. Examination showed nasal polyposis and unilateral hemianopia. Computerized tomography and magnetic resonance imaging showed bilateral nasal polyposis with intracranial extension; however, the optic nerve was free. The patient underwent functional endoscopic surgery and medical management in the form of steroids and oral antifungal therapy, resulting in complete recovery of the visual field loss. Patient was started on immunotherapy according to the skin prick test. No clinical nor radiological recurrence of the disease was evident within 2 years. Immediate management both surgically and medically is important. Immunotherapy is an essential part for long term control.