Spontaneous orbital subperiosteal hematomas in patients with liver disease

Spontaneous orbital subperiosteal hematomas are rare entities. They are often associated with systemic coagulopathies. We present two cases of spontaneous orbital subperiosteal hematomas in patients with systemic coagulopathies resulting from liver disease. One patient was diagnosed with hepatitis B and had spontaneous resolution of the hematoma. Another patient had alcoholic cirrhosis and required an orbitotomy for drainage of a hematoma for compressive optic neuropathy. With the rising incidence of hepatitis B and the prevalence of alcoholic liver disease, it is important to include liver disease in the systemic evaluation of patients with spontaneous orbital subperiosteal hematomas.