Aim: To know the different orbital manifestations and involvement of surrounding structures and their varied clinical presentations of fungal rhino-orbital sinusitis. Materials and Methods: 40 patients with orbital complications secondary to fungal rhino sinusitis from 2007 – 2017 were included in the study of 20 to 70 years of age. Endoscopic Sinus Surgery with orbital clearance / debridement were done as per the need with anti-fungal medications. Mucormycosis with orbital, palatal and intracranial involvement and Aspergillus with Abducens palsy were seen with histopathological evidence. Regular follow up and endoscopic suction clearance were done in all patients. Patients with suspected malignant involvement and traumatic injury. Results: Out of the 40 patients, 25 improved completely without any sequelae, 2 under went orbital exenteration, 5 had palatal perforation and 3 succumbed to death. Conclusion: Invasive rhinosino-orbital mycosis is known to have a poor prognosis.Ocular involvement is an ominous sign but orbit can be preserved. The critical factor in treatment is the rapidity of diagnosis and early administration of antifungal therapy because some of these patients may have a stormy course or rapid progression. A high degree of clinical suspicion is required for diagnosis. However real time total surgical excision with an appropriate antifungal therapy will make a difference in the prognosis.

Keywords: Fungal rhino sinusitis; Mucormycosis; Orbital cellulitis; Amphotericin - B.