A 14-year-old boy was referred with complaints of decreased vision, pa
in, and diplopia that developed in his right eye after trauma. Radiolo
gic studies showed an orbital roof fracture with an associated subperi
osteal hematoma. Orbital exploration with surgical drainage of the hem
atoma and roof fracture repair was performed. Postoperatively, he expe
rienced complete visual recovery with resolution of his proptosis and
diplopia. Subperiosteal hematomas of the orbit should be considered in
the differential diagnosis of acute unilateral proptosis after trauma
. The authors suggest that early intervention results in rapid patient
recovery.