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Acute visual loss may occur in association with sinusitis either as a complication of orbital cellulitis or, less frequently, as a part of the orbital apex syndrome. Originally, an orbital apex syndrome is asociated with an afection of the vesels and ne-rves pasing through the superior orbital fisure and the optic foramen. A clasical feature of orbital apex syndrome is emosis, or lid edema. We present a case of male patient with alternating bilateral visual loss with ophthalmoplegia secondary to paranasal sinusitis. (Korean J Otolaryngol 2002;45:825-7)