Anatomical and Clinical Correlations Between Nasal Pathologies and Ophthalmologic Symptoms: A Systematic Review

Background: Close anatomical, neural, and vascular relationships exist between the nasal cavity/paranasal sinuses and the orbit, leading to frequent ophthalmologic symptoms in patients with primary nasal pathologies.

Objectives: To systematically review the anatomical basis and clinical correlations of ophthalmologic manifestations arising from nasal and paranasal sinus diseases, and to evaluate emerging diagnostic and therapeutic implications, including sphenopalatine ganglion stimulation and causes of nasolacrimal duct obstruction.

Methods: A systematic literature search was conducted in PubMed, Scopus, Web of Science, and Embase from January 2000 to June 2026. Search terms included combinations of “nasolacrimal duct”, “pterygopalatine ganglion”, “sphenopalatine ganglion stimulation”, “allergic rhinoconjunctivitis”, “nasolacrimal duct obstruction”, “cavernous sinus thrombosis”, and “herpes zoster ophthalmicus”. Inclusion criteria: original studies, anatomical reviews, clinical trials, and meta-analyses. After screening 1,312 records, 92 studies were included following PRISMA guidelines.

Results: Key pathways include nasolacrimal duct continuity (with nasal septal deviation, turbinate hypertrophy, and chronic inflammation as major causes of obstruction), trigeminal and pterygopalatine ganglion neural connections, and valveless venous drainage. Hutchinson’s sign strongly predicts ocular involvement in herpes zoster ophthalmicus. Stimulation or blocking of the sphenopalatine ganglion has proven to significantly help with the nasal and eye symptoms of allergic rhinoconjunctivitis.

Our findings support the connection between the anatomy and potential treatment options for the sphenopalatine ganglion and include strong evidence for using multiple disciplines in treating individuals with allergic rhinitis, which is critical.