Delayed orbital subperiosteal hemorrhage after blunt trauma

A 21-year-old man presented with sudden-onset orbital hemorrhage, vision loss, and epistaxis 4 days after experiencing blunt trauma. Computed tomography revealed a subperiosteal hematoma in the medial orbit, extending to the orbital apex, and fractures of the medial and inferior orbital walls. After the hematoma was evacuated through a medial orbitotomy, orbital and visual symptoms improved. Although rare, vision-threatening subperiosteal hemorrhages may develop days after blunt orbital trauma and may require surgical evacuation.