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Black Eye
A black eye is the appearance of bruising around the eyes. It's usually the result of trauma to the head or face, which causes bleeding beneath...

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A black eye is the appearance of bruising around the eyes. This may occur when the small blood vessels (capillaries) beneath the skin have broken and blood has leaked into the surrounding tissue, creating discolorations. Black eye is also referred to as eye bruises and bruising around the eyes.

A black eye is usually the result of trauma to the head or face. It results in bleeding beneath the skin, which causes discoloration or bruising. Most black eyes are not serious, but sometimes can be an indicator of a medical emergency like a skull fracture.

Black eyes can appear after some surgical procedures, such as nose surgery or a facelift. A black eye may occur when blood, originating in the forehead or nose, settles by gravitational effect underneath the eye. "Raccoon eyes" refers to blood that settles underneath the eyes and is associated with a fracture in the base of the skull.

Over the course of a few days, the black and blue color of the bruises around the eyes fades to yellow or green as the blood breaks down and is reabsorbed into the surrounding tissues. Depending on the amount of blood that has collected within the skin, the tissues may require up to two weeks to return to normal color.

It’s important to be aware that unexplained bruising in someone you know may be a sign of domestic violence or abuse. Your health providers are required by law to ask you questions to make sure you are safe in your domestic situation.

Associated Diagnoses

Conditions that are likely associated with a black eye include:

  • broken nose
  • concussion
  • dengue fever
  • hemophilia A
  • hemophilia B
  • epidural hematoma
  • eye emergencies
  • head injury
  • factor II deficiency
  • factor V deficiency
  • factor VII deficiency
  • factor X deficiency
  • shaken baby syndrome
  • skull fracture
  • subdural hematoma
  • von Willebrand disease

Diagnosis

If you seek medical treatment for a black eye, your doctor will perform a basic examination. They will also ask how the injury occurred and inquire about additional related injuries.

Your vision will be tested by shining a light into your eyes. The doctor will also ask you to follow his finger with your eyes.

If it is suspected that you have a fracture on any part of the skull, a CT scan and X-ray of the face and head will be done. If an injury to the eye itself is suspected, you will be referred to an ophthalmologist. The doctor may put a dye in your eye to test for eyeball abrasions. If a head injury is suspected, you will be referred to a neurosurgeon. If fractures of the face are suspected, you will be referred to an ENT specialist.

Treatment

Black eyes due to a minor injury can be treated with rest, ice, and pain medication. A follow-up visit with your doctor will be suggested if you have any visual changes or lingering pain. If swelling and pain accompany bruising, apply a cold compress for 20 minutes on, and 20 minutes off, until the swelling is reduced. When the swelling is reduced, you may apply a warm compress to help promote reabsorption of the blood.

For any pain and throbbing, you may take a pain reliever such as ibuprofen or acetaminophen. You should also avoid putting any pressure over the affected area.

There are many home remedies you can use to treat your black eye. It is important that you use ice or an ice pack on the eye. People often like to use frozen packs of raw meat on their eye. Avoid doing this, as these packs may contain harmful bacteria.

Arnica is a good herbal remedy to reduce swelling, while 5 tablespoons of melted Vaseline with cayenne pepper serves as a good healing ointment. Be careful because this will burn. Vitamins C and K will also promote healing and reduce swelling.

Black Eye in Children and Toddlers

Small children will need a cold compress placed on their eye for 15 minutes at a time throughout the day. They may also be required to wear an eye shield because the swelling can force the eye shut.

At home, hold your child’s head higher than their heart for a day or two. Try to keep them from being too active. Also, keep your child from rubbing their eye.

When to Seek Immediate Medical Treatment

Black eyes are accompanied by an assortment of symptoms that could require medical attention.

A black eye may be the repercussion of a facial fracture. You need to seek immediate medical attention for any broken bones on your face or skull.

If headaches persist or there is a loss of vision or consciousness, your black eye may be the symptom of a concussion or fracture. Other symptoms of a concussion include:

  • nausea
  • vomiting
  • dizziness
  • lethargy
  • memory lapses

Other serious concerns are blood or clear fluid draining from the nose or ear. Blood on the surface of the eyeball is also a cause for concern. This can be a sign of a ruptured eyeball or damaged blood vessels in the eye. This may cause additional swelling and infection that can make your eye immobile and blur your vision.

Complications

Sometimes black eyes can occur without trauma affecting the eye. If you have bad nasal allergies, you can get something called “allergic shiners.” These shiners may cause dark circles or the appearance of a black eye because of the blood flow being slightly hindered. The small veins under the eye will pool with blood and enlarge because the blood is getting back to the heart more slowly.

Although highly unlikely, a black eye in a child without any sign of trauma can be an early symptom of myeloid leukemia.

Outlook

Most cases of black eye can be treated at home with ice, rest, and pain relievers. A black eye can last anywhere from one to two weeks as the bruising heals and the blood is slowly absorbed back into the skin.

Things to avoid while recovering from a black eye are:

  • applying too much pressure
  • putting heat on the affected area
  • playing sports or being overly active in a way that sets you up for further injury
Written by: J. C. Jones, MA, RN, and Justin Sarachik
Edited by:
Medically Reviewed by:
Published: Dec 1, 2014
Published By: Healthline Networks, Inc.
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