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May 1997

Bilateral Spontaneous Subperiosteal Hematoma of the Orbits: A Case Report

Author Affiliations

Omaha, Neb
Portland, Ore
Eugene, Ore

Arch Ophthalmol. 1997;115(5):679-680. doi:10.1001/archopht.1997.01100150681026

Spontaneous and secondary subperiosteal hematomas of the orbit have many origins and are uncommon. We are unaware of any published case of bilateral spontaneous subperiosteal hematoma of the orbits.

Report of a Case.  A 33-year-old woman experienced sudden onset of diplopia, swelling, progressive decrease in vision, and pain in her left orbit, followed shortly by similar symptoms in her right orbit. She denied previous ocular problems, trauma, or fever, but related a history of alcoholic liver disease with coagulopathy.Results of an examination revealed a visual acuity of 20/400 OU with poorly reactive pupils, bilateral periorbital ecchymoses, chemosis with conjunctival prolapse, and exotropia with limitation of supraduction in both eyes (Figure 1).An orbital computed tomographic scan showed bilateral, remarkably symmetric, lenticularshaped orbital masses. These enhanced mildly and were consistent with subperiosteal hematomas (Figure 2). Laboratory studies revealed a normal platelet count of 153×109/L and an elevated prothrombin

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