A 55-year-old male presents with a severe headache, facial pain, and fever. He also reports double vision and swelling around his right eye. He has a history of chronic sinusitis. On examination, his right eye appears bulging (proptosis) and he has impaired eye movement. What could be the cause, and what should be done next?
This patient's symptoms suggest a possible complication of sinusitis known as orbital cellulitis, which is an infection that has spread to the tissues around the eye. This is a serious condition that can lead to vision loss and even life-threatening complications like meningitis or a brain abscess. Immediate referral to the emergency department is warranted. IV antibiotics will likely be started, and imaging such as a CT or MRI of the orbits and sinuses will be done. Depending on the severity, surgical intervention may be necessary.