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Background: Optic disc edema is a pathological condition with various causes. Cases of optic disc swelling should be dealt with a multidisciplinary approach to rule out those causes. Unilateral optic disc edema is seen in papillitis, non-arteritic anterior ischemic optic neuropathy, retinal vein occlusion, and infection or inflammation of the contiguous sinus or orbit. Here, we report a rare case of unilateral asymptomatic optic disc edema due to posterior ethmoid sinusitis.   Case Presentation: A 53-year-old man presented for a routine 3-monthly follow-up after an uneventful cataract surgery of the right eye. All examinations were unremarkable, except for the right eye optic disc edema on fundus examination, consistent with an enlarged blind spot in the visual field test. Contrast-enhanced magnetic resonance imaging revealed mucosal thickening with muco-inflammatory exudates of the posterior ethmoidal sinus overriding the optic disc on the right side, leading to optic disc edema of the right eye. The patient was diagnosed with unilateral asymptomatic optic disc edema in the right eye due to posterior ethmoid sinusitis and referred to an otorhinolaryngologist for the management. The otorhinolaryngologist performed functional endoscopic sinus surgery and prescribed antibiotics and anti-histamines for 6 weeks. At the final examination, his visual acuity was 6/6, and the fundus examination revealed no optic disc edema. Conclusions: We reported a rare case of unilateral optic nerve edema and visual field loss with a treatable cause. Contemporary imaging provided the accurate diagnosis. Therefore, in cases of disc edema, sinusitis of the adjacent paranasal sinuses should be ruled out as a possible cause of compressive optic neuropathy or inflammation overriding the optic nerve.

Purpose: To analyze the effect of anatomical and functional outcome of large diameter chronic macular holes by managing through a novel Surgical Technique which includes Traction Release ILM Peeling (TRILMP) without manipulating the flap using only silicone oil tamponade. Design: Prospective Cohort study.Subjects: A prospective study of 15 patients having stage 4 chronic large diameter macular holes were recruited by stratified random sampling technique.Methods: Contrary to the conventional inverse ILM peeling surgery, a modified TRILMP technique was used for all chronic macular hole cases. Surgical procedure was performed in 15 patients by a single surgeon. Functional visual outcome was measured by Log MAR visual acuity charts and anatomical closure by OCT imaging to calculate the basal hole diameter, the minimum hole diameter and hole form factor (HFF). Main outcome measures:Both anatomical and functional factors involving hole form factor, basal hole diameter and visual improvement postoperatively were analyzed.Results: Fourteen of 15 eyes (93%) had type 1 closure with a mean basal hole diameter of 1249 ± 174μm and one eye (7%) had type 2 closure with a basal hole diameter of 1683μm. A statistically significant improvement in the visual outcome with p<0.05 was found between pre and post-operative Log MAR values. A significant negative correlation (p=0.04) was found between hole form factor (HFF) (Mean = 0.54) and post-operative Log MAR visual acuity. Similarly, a significant positive correlation (p=0.001) was found between basal hole diameter and postoperative Log MAR visual acuity. Functional visual improvement of 61% was achieved 6 months postoperatively where the maximum visual acuity improved from log 1.3-log 0.3. Conclusion:A lone tamponade of silicone oil was used along with a novel Surgical Technique adopting traction release ILM peeling without manipulating the flap remnant around macular hole edge, which gave an enhanced anatomical and functional result even in macular holes with larger basal diameter and a medium HFF.

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