Case Report: We present the case of a 33 year old woman who presented with ophthalmic symptoms and was originally investigated by the ophthalmology department. Subsequent computerised tomography indicated maxillary atelectasis and hypoglobus. A radiological diagnosis of silent sinus syndrome was made and definitive endoscopic sinus drainage performed.Conclusions: This report highlights a rare condition, which often presents to a non ENT specialist.Computerised tomography is essential for diagnosis. The underlying mechanism thatproduces this condition is unclear. Initial treatment should be in the form of a definitive sinusdrainage procedure. Failure of the facial asymmetry to improve may necessitate orbital floorreconstruction. The rarity of this condition means that few clinicians encounter cases during their careers. Awareness of silent syndrome is important as correctly treated a full recovery can be achieved.

Keywords: silent sinus, enophthalmos, maxillary sinusitis, atelectasis, treatment