I have throbbing pain around nasal bone with headache and visual disturbance. Please interpret my MRI.

Question

Hello doctor,

I have six weeks of ongoing problem with throbbing pain around the nasal bone, headache at the top of my head and visual disturbances. MRI showed air bubble in the sphenoid sinus. What should be my next step now? I had a sudden onset, nasal pain accompanied with visual problems (not clear vision). I consulted an eye clinic, according to them, it is a systematic problem. I have tinnitus as well that started suddenly around the same time as my nasal pain.

Answer 1

Hello,

Welcome to icliniq.com.

Considering that it is a sudden onset, it seems like something you should not ignore. It seems like you are suffering from a complication of chronic sinusitis. Pain near the nasal bone and headache are symptoms of sinusitis. Since the nerve that supplies the eye passes near the sphenoid sinus and the other sinuses are in the proximity of the eye, any infection in them can spread to the orbit and cause symptoms. This however should have been seen partially on an MRI. What you need to do next is get a CT (computerized tomography) scan of the nose and paranasal sinuses done. This will show the extent of the sinus infection as well as the bony landmarks and spread into the orbit. This cannot be seen clearly on an MRI. If it shows spread is the cause of the blurring of vision, you will have to get operated to clear the sinuses and prevent further damage. If sinuses are clear, then other causes have to be ruled out for the visual problem. Also, get your blood sugar done, since diabetes is another reason for blurring of vision.