The general clinical, ophthalmologic, and radiologic features of three pati
ents with silent sinus syndrome are presented. All three patients were trea
ted surgically. The cases of these patients illustrate the spectrum of pres
entation of silent sinus syndrome, including enophthalmos, hypophthalmos, t
ransient vertical diplopia, lid retraction, lagophthalmos, and blurred visi
on. All patients had sinus disease, and all patients improved after surgery
using functional endoscopic sinus surgery techniques. The protean manifest
ations of silent sinus syndrome can be identified, thereby allowing appropr
iate management.