We examined 45 (23 male and 22 female) Japanese patients with paranasal sinus mucopyoceles associated with ophthalmic complications. The patients ranged in age from 31 to 87 years. The patient distribution by the affected sinus was as follows: maxillary sinus alone, 17 patients; ethmoidal sinus alone, 9 patients; frontoethmoidal sinuses, 9 patients; frontal sinus alone, 7 patients, and other multiple sinuses, 3 patients. Thirty-nine mucoceles and 6 pyoceles were identified. Ophthalmic signs and symptoms included lid swelling, ocular pain, pseudoptosis, proptosis, displacement of the eyeball, epiphora, slight blurring of vision, severely decreased visual acuity, visual field abnormality, diplopia, disk edema, retinoichoroidal folds and increased intraocular pressure. Of the 45 patients, 1 had a history of sinus trauma and 29 had a history of sinus surgery.