BMJ Case Reports 2012; doi:10.1136/bcr-03-2012-5974
  • Reminder of important clinical lesson

Frontal sinus mucoceles presenting in the upper eyelid: an easily missed diagnosis

  1. Claire Morton3
  1. 1Department of Ophthalmology, Abertawe Bro Morgannwg University Health Board, Swansea, UK
  2. 2Department of Ophthalmology, Betsi Cadwaladr University Health Board, St Asaph, UK
  3. 3Department of Ophthalmology, HM Stanley Hospital, St Asaph, UK
  1. Correspondence to Dr Soon Wai Ch’ng, wcsw81{at}


Frontal sinus mucoceles are epithelium-lined mucus-containing sacs that are capable of bony expansion causing a spectrum of ophthalmological symptoms. If left untreated, they can erode the thin sinus wall causing life-threatening complications such as meningitis. We would like to alert the clinicians to this diagnosis that can be easily misdiagnosed. The first patient appeared to have an allergic blepharo-conjunctivitis that was not responding to topical and systemic medications. The second patient presented with recurrent preseptal cellulitis unresponsive to oral antibiotics. CT imaging of both patients revealed frontal sinus mucoceles. Both patients recovered well with sinus surgery. Management of these patients needed a close liaison with our ENT and radiology colleagues to warrant a good outcome.


  • Competing interests None.

  • Patient consent Obtained.

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