Fungal infections of the orbit are uncommon but when present can be vision and life threatening. The two most common fungal diseases with orbital manifestations are mucormycosis and aspergillosis. Most of these infections start in a paranasal sinus and secondarily invade the orbit. Mucromycosis usually affects debilitated individuals, especially diabetics in ketacidopsis or patients immunosuppressed after cancer chemotherapy. Aspergillosis has several different clinical presentations and can affect debilitated and normal individuals. Patients with advanced AIDS are also at risk of developing sino-orbital aspergillosis. This article reviews the clinical presentations, imaging characteristics, diagnosis, treatment, and prognosis of patients with fungal orbital infections. Newer therapies, including new antifungal medications and hyperbaric oxygen, are discussed.
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