Objective　To analyze the imaging anatomical and clinical characteristics of fungal sinusitis, which is dominated by eye symptoms.　Methods　Two hundred and eighty-five patients with fungal sinusitis admitted to the department of otolaryngology and neck surgery in three hospitals from January 2008 to January 2018 were selected, and the clinical data of 20 patients in the first consultation ophthalmology were collected, the characteristics and causes of clinical misdiagnosis were analyzed.　Results　The lesions of the 20 cases first consultation ophthalmology were mainly located in sieve sinus (3 cases), sphenoid sinus (2 cases), maxillary sinus combined with ethmoid sinus (3 cases), 8 cases of ethmoid sinus combined with sphenoid sinus, maxillary sinus combined with ethmoid sinus and sphenoid sinus (4 cases). The ocular symptoms mainly included unilateral swelling pain, diminution of vision, vision change, facial pain and headache.　Conclusions　Patients admitted to the department of ophthalmology with unilateral swelling pain and diminution of vision should consider the possibility of fungal sinusitis and then should be transferred to department of otolaryngology for treatment after sinus CT examination.