Definition

What is a black eye?

A black eye, also known as a periorbital hematoma, refers to bruising of the tissue under the skin around the eye. In most cases, the injury affects the face rather than the eye itself.

How common is a black eye?

Please discuss with your doctor for further information.

Symptoms

What are the symptoms of a black eye?

Pain, swelling, and bruising are the most common signs and symptoms of a black eye.

  • Initially, the swelling and discoloration may be mild. The eye may start off slightly reddened, then progress to a darker shade.
  • Later, the skin around the eye becomes deep violet, yellow, green, or black in color.
  • Swelling increases as discoloration progresses.
  • Over the course of a few days, the area becomes lighter and the swelling decreases.

Although some blurry vision or difficulty opening the eye may occur because of the swelling, more serious visual problems are less common.

Headache may also be present, because the usual cause of a black eye is some sort of head injury.

Signs of a more serious injury are:

  • Double vision
  • Loss of sight
  • Loss of consciousness
  • Inability to move the eye
  • Blood or clear fluid from the nose or the ears
  • Blood on the surface of the eye itself
  • Persistent headache

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

Most black eyes are minor injuries that heal on their own in a few days with ice and pain medications. An eye doctor (ophthalmologist) should examine the injured eye to make sure no significant injury to the eye has occurred.

Call your doctor if these conditions develop with a black eye:

  • Changes in vision
  • Severe pain continues
  • The swelling is not related to an injury
  • Signs of infection (for example, warmth, redness, pus-like drainage).
  • You are unsure about treatment or concerned about symptoms.
  • Swelling does not start to improve after a few days.

Seek immediate medical care for these conditions:

  • Changes in or loss of vision, especially double vision
  • Inability to move the eye (for example, unable to look in different directions)
  • Any injury in which you think an object pierced the eye or may be inside the eyeball
  • Obvious blood in the eye
  • Deformity to the eye or fluid leaking from the eyeball
  • Any lacerations (cuts) to the eye area
  • You should contact your doctor if you have any of the following:

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes a black eye?

The most common cause of a black eye is a blow to the eye, forehead, or nose. Depending on where the blow lands, one or both eyes may be affected.

  • A blow to the nose often causes both eyes to swell because the swelling from the nasal injury causes fluid to collect in the loose tissues of the eyelids.
  • Surgical procedures to the face, such as a facelift, jaw surgery, or nose surgery, can cause black eyes.
  • A certain type of head injury, called a basilar skull fracture, causes both eyes to swell and blacken. This condition is typically described as “raccoon’s eyes.”
  • Other causes of swelling around the eye include allergic reactions, insect bites, cellulitis (skin infection around the eye), angioedema (a hereditary condition causing swelling, usually around both eyes), and dental infections. However, these conditions do not make the skin turn black and blue around the eye.

Risk factors

What increases my risk for a black eye?

Please consult with your doctor for further information.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is a black eye diagnosed?

For most black eyes, a basic physical examination is all that is required.

The doctor asks about the facts in regard to the injury and looks for associated injuries or symptoms.

The basic physical examination includes checking the patient’s vision, shining a light into the eyes to look at the pupils and inside the eye itself for any injury, testing the motion of the eye (following the doctor’s finger with the eyes), and examining the facial bones around the eye.

Depending on what is found, the doctor may perform additional testing.

  • The doctor may put a dye on the eye and look at the eye under a special light to check for abrasions to the eyeball or foreign bodies (objects).
  • If the doctor suspects the patient may have a fracture to the bones of the face or around the eye (the orbit), an X-ray or a CT scan may be ordered. This may also be done if the doctor suspects that something is inside the eye.
  • If there are any special concerns, the doctor will refer the patient to an appropriate specialist, such as an ophthalmologist (a medical doctor who specializes in eye care and surgery), for follow-up

How is a black eye treated?

The doctor will normally recommend home treatment, such as ice and acetaminophen.

If the physician suspects a more serious injury, the patient will be referred to a specialist.

Black Eye Self-Care at Home

Rest and ice applied early after the injury help decrease swelling and pain.

Ice helps decrease swelling by constricting blood vessels, by decreasing fluid accumulation, and by cooling and numbing the area.

  • Apply ice for 20 minutes an hour every hour while awake, for the first 24 hours. Do not apply ice directly to the injury.
  • To avoid potential cold injury to the site, wrap the ice in a cloth or use a commercial ice pack. A bag of frozen vegetables wrapped in a cloth makes a good ice pack.

Protect the area from further injury. Avoid athletic or other possibly injurious activities until the eye has healed.

Do not put a steak or a piece of raw meat on a black eye. Putting potentially bacteria-laden meat on a mucous membrane or an open skin injury can be dangerous.

Black Eye Medical Treatment

For simple, uncomplicated black eyes, the treatment prescribed is similar to home treatment: ice, over-the-counter pain medications (avoid aspirin-unless prescribed by a doctor or cardiologist for a heart condition – because this may increase bleeding), rest, and protection of the injured area.

For more complicated injuries, the patient may be referred to an appropriate specialist:

  • A neurosurgeon for injuries to the skull or the brain
  • An ophthalmologist for injuries to the eye itself
  • An otorhinolaryngologist [ear, nose, and throat (ENT)] for fractures to the face
  • An oral/maxillofaical surgeon for fractures to the face
  • A plastic surgeon to repair serious cuts to the face

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage a black eye?

The following lifestyles and home remedies might help you cope with a black eye:

  • Check your home for items that might cause a fall, such as throw rugs or objects on the floor. This will decrease injuries for both the elderly and children.
  • Wear appropriate protective gear for any athletic or work-related activity to help protect against not only black eyes but also other serious injuries.
  • Wear goggles or other eye protection when working, doing yard work, or other hobbies and sports to help prevent all types of eye injuries.
  • Wear seat belts while driving and wear helmets when riding a motorcycle or bicycle.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: October 18, 2017 | Last Modified: October 18, 2017

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