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How sinuses affect the eyes, and what you can do about it

woman with sinusitis affecting her eyes

Can a sinus infection affect your eyes?

A sinus infection (sinusitis) can cause pain around your eyes, eyelid swelling and other symptoms that can affect your vision. Get eye pain and vision changes checked out by an eye doctor as soon as possible to avoid vision loss, eye problems and other health issues.

What is sinusitis?

Sinusitis is an inflammation or infection of the sinuses, which are hollow spaces near your eyes and nose. The sinuses make mucus, which drains out through your nose. Typically filled with air, a blockage in the sinuses causes them to fill with fluid. This extra fluid promotes germ growth and the potential development of a viral, bacterial or fungal sinus infection.

The maxillary sinuses (the sinuses below your eyes) are the ones most likely to get infected. A maxillary sinus infection may cause pain below the eyes and in the cheeks. You also have sinuses: 

  • Between your eyes (ethmoidal sinuses)

  • Behind your eyes (sphenoidal sinuses

  • Above your eyes (frontal sinuses

A sinus infection may cause you to experience the following symptoms:

  • Headache

  • Congested or runny nose

  • Facial pain

  • Cough

  • Fever

  • Sinus pressure

  • Sore throat 

  • Bad breath

A sinus infection may clear up in less than a month with treatment. However, some patients may develop chronic or recurring sinus infections.

Eye symptoms linked to sinusitis

In addition to eye pain or sinus pain behind the eyes, there are other eye symptoms that may be caused by sinusitis or other sinus issues. These may include:

  • Sinus pressure and eye pain – A sinus infection may cause you to feel pain behind your eyes or around the eye area on your face. This may feel like pain in your eyes or a headache behind your eyes.  

  • Sinus pressure and eye watering – In some cases, a chronic sinus infection can lead to watery eyes (epiphora). But these symptoms may also be caused by many other conditions. For example, a cold or allergies may cause eye watering and a feeling of stuffiness or pressure. And a cluster headache can similarly cause pressure, watery eyes and stuffy nose. 

  • Sinus pressure and swollen eyes – A sinus infection can also lead to eyelid swelling and eye puffiness. This can occur when the sinuses between and below your eyes may become inflamed and clogged with mucus. The swelling typically goes away as your sinusitis improves with treatment.

Sinus problems such as chronic sinusitis can also cause blurry vision, vision loss and other problems due to optic nerve damage caused by chronic inflammation, although this is rare. 

In some cases, eye symptoms can be a sign of a sinus infection spreading to the eye, or other serious sinus infection complications.

Can you get a sinus infection in your eyes?

In some cases, a sinus infection can spread to the eyelid, skin and soft tissues. Periorbital cellulitis, also known as preseptal cellulitis, can occur when the area around the eye, including the eyelid, becomes infected. Orbital cellulitis can occur if the eyeball itself, and the tissues around the eyeball, become infected. Periorbital cellulitis cannot develop into orbital cellulitis because a fibrous tissue surrounding the eyeball serves as a barrier. 

Both of these conditions are more common in children than in adults. Periorbital cellulitis is more common and less dangerous than orbital cellulitis. Both conditions can cause red, swollen and painful eyelids. Fever may sometimes occur with periorbital sinusitis, although it is more common in orbital cellulitis. It is important to note that periorbital cellulitis does not typically affect vision or eye movement. 

In addition to the symptoms above, symptoms of orbital cellulitis also may include:

  • Fever

  • Malaise (general sense of being sick or uncomfortable)

  • Headache

  • Eye is pushed forward (proptosis)

  • Blurry vision

  • Double vision

  • Eye pain, especially when moving the affected eye

If orbital cellulitis has been ruled out, you may be able to treat periorbital cellulitis at home with oral medications with close supervision by an ophthalmologist. Orbital cellulitis typically requires hospitalization and IV antibiotics. It is important to see a doctor right away if you think you or your child may have either condition.

Other sinusitis complications that can affect the eyes

There are other sinusitis complications that can affect your vision, though most are rare. It's still a good idea to know about these problems so you can get medical care right away if necessary.

Cavernous sinus thrombosis

Cavernous sinus thrombosis (CST) is a rare but dangerous condition that can be a complication of a sinus infection. It usually starts in one eye and spreads to the other eye. The most common symptoms are fever and headache, which may appear along with eye issues. Several eye-important arteries and nerves pass through the cavernous sinus, so damage to this area can result in a number of eye complications. 

Eye symptoms of CST may include:

Less common symptoms may include confusion, face numbness, a stiff neck or coma. It's crucial to seek treatment right away because CST can be life-threatening and may cause blindness in up to 15% of cases. Treatment for CST typically requires antibiotics, antifungal medication and medicine to help prevent blood clots.

Bacterial meningitis

Bacterial meningitis is a rare complication of a sinus infection. It is an emergency condition. The most common symptoms of meningitis include sudden headache with fever and a stiff neck

Meningitis symptoms may also include:

  • Confusion

  • Sensitivity to light (photophobia)

  • Nausea

  • Vomiting

It's important to see a doctor right away if you suspect meningitis because the condition can be life-threatening. Prompt treatment with antibiotics is key to recovery.

When to seek emergency medical care 

If you've been diagnosed with or suspect sinus issues that may be affecting your eyes, you may need to see a doctor right away. 

Seek emergency medical care if you have:

  • High fever

  • Stiffness of the neck

  • Breathing difficulty

  • Confusion 

  • Blurry vision or other vision changes

  • Eye swelling and pressure

  • Severe pain in or around the eyes

  • Swelling around one or both eyes

If in doubt about your symptoms, it's best to seek emergency care right away to protect your overall health as well as your eye health and vision.

Eye pain. MedlinePlus. April 2022.

Sinusitis. Johns Hopkins Medicine. Accessed April 2022.

Sinus infection (sinusitis). Cleveland Clinic. June 2020.

Pain in the quiet (not red) eye. American Family Physician. July 2010.

An association between acquired epiphora and the signs and symptoms of chronic rhinosinusitis: a prospective case-control study. American Journal of Rhinology. March – April 2003.

Cluster headache. MedlinePlus. Accessed April 2022.

What's causing eyelid swelling after my sinus infection? American Academy of Ophthalmology. September 2018.

What to do about sinusitis. Harvard Health. January 2020.

Optic nerve changes in chronic sinusitis patients: correlation with disease severity and relevant sinus location. PLOS One. July 2018.

Preseptal and orbital cellulitis. MSD Manual Professional Version. August 2021.

Cavernous sinus thrombosis. StatPearls. November 2021.

Intracranial suppurative complications of sinusitis. Scandinavian Journal of Surgery. February 2016.

Bacterial meningitis. Centers for Disease Control and Prevention. July 2021.

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