Bilateral Sphenoid Mucocele Presenting with Decreased Visual Acuity

¹Ophthalmology Clinic, EPS CHU A.-Le Dantec, BP 17225, Dakar Liberté, Senegal

^*Corresponding author: Dr Aboubacry Sadikh SOW, Ophthalmology Clinic, EPS CHU A.-Le Dantec, BP 17225, Dakar Liberté, Senegal, Phone: 00221775659760, Email: [email protected]

Received Date: August 25, 2026

Published Date: October 12, 2026

Citation: Sow AS, et al. (2026). Bilateral Sphenoid Mucocele Presenting with Decreased Visual Acuity. Mathews J Ophthalmol. 11(1):41.

Copyrights: Sow AS, et al. © (2026).

ABSTRACT

Introduction: Naso-sinus mucoceles are benign, inflammatory pseudocystic lesions that most commonly occur in the anterior fronto-ethmoidal region. Sphenoid involvement is rare, and bilateral cases are exceptional. We report a case of bilateral sphenoid mucocele that presented with decreased visual acuity.

Observation : The patient was a 45-year-old woman with a history of chronic headaches persisting for over six years treated with standard analgesics who presented with progressive distance vision loss that had been evolving for nearly six years, unaccompanied by ocular pain, diplopia, or other neuro-ophthalmological symptoms. Ophthalmological examination of the right eye revealed a corrected visual acuity of no light perception, exotropia, dry eye, and an relative afferent pupillary defect (RAPD); fundus examination showed optic disc pallor and temporal peripapillary atrophy. In the left eye, corrected distance visual acuity was 10/10, and dry eye, a normal pupillary light reflex, and a normal fundus were noted. The otolaryngological examination revealed congestion of the oropharynx with mild enlargement of the palatine tonsils. The OCT showed, in the right eye, very severe thinning of the RNFL and GCL with preservation of the inferonasal sector, and in the left eye, thickening of the RNFL in the inferonasal sector with a sectoral defect in the GCL in the superior sector. The MRI showed bilateral ballooning of the sphenoid cells with mixed fluid and blood content in some areas; the fluid component appeared as a T1-hyposignal and T2-hypersignal, while the blood component appeared as a T1- and T2-hypersignal. Color vision and visual field examinations had not been performed. The patient underwent endoscopic endonasal surgery.

Discussion: Sphenoid mucocele is rare. Functional Endoscopic Sinus Surgery (FESS) is currently the treatment of choice for sphenoid sinus mucocele.

Conclusion: This is a benign condition that progresses slowly and responds well to treatment. Endoscopically guided surgery is the standard of care.

Keywords: Mucocele, Sphenoid, Decreased Visual Acuity