We present a case of rapid progressive unilateral visual loss in a 69-year-old woman who presented with facial pain, ipsilateral proptosis and restriction of eye movements, and nasal symptoms suggestive of sinusitis. A diagnosis of allergic aspergillus sinusitis was made on the basis of local histopathology and systemic features. Over a three-week period vision deteriorated to bare perception of light but showed a dramatic improvement to a level of 6/9 central vision on systemic steroid therapy. The mechanism of visual failure in the context of allergic aspergillus sinusitis and the therapeutic implications are discussed.
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