We report a patient with a spontaneous intramuscular hematoma in the lateral rectus muscle of the eye that resolved without medication with maintenance of good vision. A 40-year-old woman presented with ocular pain and exophthalmos in her right eye. She had no history of trauma or surgery. Exophthalmos and limitation of abduction and supraduction of her right eye were present at the initial examination. Magnetic resonance (MR) images showed an intramuscular hematoma in the right lateral rectus muscle. Her other ocular findings were within normal limits. Five months later without any treatments, the MR images were within normal limits, and her ocular signs and symptoms were completely resolved. Careful observations including MR imaging is sufficient for patients with a spontaneous intramuscular hemorrhage in the extraocular muscle, and the visual prognosis is good.
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