From the Guidelines
Trauma is the primary cause of spontaneous periorbital hematoma.
Common Causes of Periorbital Hematoma
- Traumatic injury, such as motor vehicle collision, sports injury, falls, and assault, is the leading cause of noncongenital monocular vision loss in children 1
- Common signs of orbital injuries include periorbital soft tissue swelling, ecchymosis, hyphemia, subconjunctival hemorrhage, diplopia, restriction of ocular movement, or vision loss 1
Mechanism of Injury
- Orbital fractures, particularly orbital roof fractures in children <8 years of age, and orbital floor fractures in older children, can lead to periorbital hematoma 1
- Trap door orbital fracture can cause entrapment of the extraocular muscles or other orbital contents, leading to restriction of ocular movement and diplopia 1
- Soft tissue swelling, hematoma, or nerve paresis can also lead to restricted ocular movement 1
From the Research
Causes of Spontaneous Periorbital Hematoma
The causes of spontaneous periorbital hematoma can be varied and include:
- Vascular anomalies 2
- Bleeding disorders 3
- Autoimmune vasculitis, such as Behcet disease 3
- Chronic sinusitis 4
- Arterial hypertension 5
- Sickle-thalassemia 6
Associated Conditions
Spontaneous periorbital hematoma can be associated with other conditions, including:
- Subperiosteal hematoma of the orbital roof 6
- Periorbital bone infarction 6
- Diffuse sinonasal disease 4
Diagnosis and Treatment
Diagnosis of spontaneous periorbital hematoma is typically made using imaging studies, such as computed tomography scans 6, 4, 5. Treatment may involve surgical evacuation of the hematoma, especially if visual function is compromised 2, 3, 4, 5. In some cases, needle aspiration or drainage may be sufficient 6, 5. Early treatment is crucial to prevent permanent visual loss 3, 4.