What causes a periorbital hematoma without trauma?

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Last updated: April 18, 2025View editorial policy

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Differential Diagnosis for Eye Hematoma without Trauma

  • Single most likely diagnosis
    • Hypertension: This is a common cause of spontaneous eye hematoma, as high blood pressure can lead to the rupture of small blood vessels in the eye.
  • Other Likely diagnoses
    • Bleeding disorders (e.g., hemophilia, von Willebrand disease): These conditions can increase the risk of spontaneous bleeding, including in the eye.
    • Anticoagulant use: Patients taking anticoagulant medications (e.g., warfarin, aspirin) are at higher risk of bleeding, including eye hematomas.
    • Diabetes mellitus: Diabetic retinopathy can cause blood vessels in the eye to become fragile and prone to bleeding.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Malignancy (e.g., orbital or ocular tumors): Although rare, eye hematomas can be a presenting symptom of underlying cancer.
    • Infections (e.g., endophthalmitis, orbital cellulitis): Infections can cause eye hematomas and require prompt treatment to prevent serious complications.
    • Vascular malformations (e.g., arteriovenous malformations): These conditions can cause spontaneous bleeding and may require urgent intervention.
  • Rare diagnoses
    • Amyloidosis: This condition can cause blood vessel fragility and increase the risk of spontaneous bleeding, including in the eye.
    • Scurvy: Vitamin C deficiency can lead to blood vessel fragility and increase the risk of bleeding, including eye hematomas.
    • Ehlers-Danlos syndrome: This genetic disorder can cause blood vessel fragility and increase the risk of spontaneous bleeding, including in the eye.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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