Frontal sinus abscess leading to blindness in adults: A case report and literature review

Frontal sinus abscesses rarely result in permanent visual loss but can present substantial reconstructive challenges when associated with orbital and craniofacial structural compromise. Herein, we report the case of a 66-year-old man with a history of craniofacial trauma and prior frontal sinus surgery who presented with progressive orbitofrontal symptoms, marked exophthalmos, globe displacement, and acute visual deterioration. Delayed source control led to profound vision loss and progressive disruption of the frontal–orbital framework, with implications extending beyond infection control to craniofacial stability and function. The patient underwent unilateral endoscopic frontal sinusotomy and drainage through a scalp fistula, achieving rapid resolution of the infection and substantial improvement in proptosis and globe position; however, visual acuity did not recover due to ischemic optic neuropathy. This case underscores that prompt diagnosis and multidisciplinary management are essential not only to prevent related complications but also to facilitate early reconstructive assessment, staged reconstruction, and long-term surveillance to limit delayed craniofacial deformity.