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.
It is called a "black eye" because of the bluish-dark color of the bruising in the tissue around the eye. This happens because the capillaries, or tiny blood vessels, have burst and leaked blood under the skin.
As fluids collect in the space around the eye, bruising, swelling, and puffiness will result. This can make it difficult to open the eye. Vision may blur temporarily. There may be pain around the eye, and possibly a headache.
Bleeding inside the eye also need's medical care, as there could be eye damage that could lead to vision problems.
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Causes of a black eye
A black eye normally refers to bruising of the area around the eye.
A black eye can happen when a person is struck on the face by a ball, a fist, a door, or other item.
Black eyes may also occur after cosmetic surgery to some parts of the face, or even certain kinds of dental work. The bruising can last for several days.
A black eye itself is not dangerous, and it is usually due to bruising around the eye, but it can sometimes be a sign of a more serious condition.
Bruising round both eyes, known as raccoon eyes, may indicate a skull fracture or other type of head injury. It requires urgent medical attention.
Effects of a black eye
If a person receives an injury to the area around the eye, they are likely to notice some swelling.
As the swelling spreads, the color of the skin will change. First, it will be red, then it will gradually change to dark blue, deep violet, and possibly black.
Pain may be felt either constantly, or only if someone touches the affected area.
Within a few days, the swelling will decrease, and the discoloration becomes lighter. The dark colors gradually fade after a few days, from dark blue, violet, or black, to a yellowish-green.
Vision problems, usually blurriness, may occur.
A black eye normally disappears within 1 to 2 weeks, and it does not normally need medical attention.
When should you see a doctor?
Although a black eye will normally heal without medical intervention, it can sometimes be a sign of something more serious.
If double vision occurs, the person should see a doctor.
The biggest concern with any head injury is to ensure that there is no skull fracture, no hematoma that is affecting important structures such as the eyes, and no bleeding or swelling within the brain.
A number of symptoms may indicate that these complications are present.
If the following occur, urgent medical attention is needed:
- Bleeding from the nose or ears
- Blood on the surface of the eye or an inability to move the eye
- Two black eyes, potentially indicating a fractured skull
- A loss of consciousness at the time of an accident or after
- Seizures or vomiting
If the person has persistent vision problems, double vision, a feeling that something is in the eye, or difficulty moving the eyes, or if they a have a headache that lasts more than 2 days, they should also see a doctor.
Treatment for a black eye at home
Ice can help to relieve the swelling and discomfort of a black eye. The person should apply ice for around 15 minutes every hour during the first day, and five times during the second.
The ice pack should not be pressed too hard, nor should it be applied directly onto the most injured part.
An ice pack can be used, ice wrapped in a cloth, or a bag of frozen vegetables, wrapped in a cloth. Ice should not be placed directly onto the skin.
On the third day, a warm compress may help.
There is no evidence to show that placing a raw steak on a black eye will help to heal it. Raw meat contains bacteria that should not be in contact with the mucous membrane of the eye.
The eye should be protected during the recovery. It is best to refrain from any activity that could further damage the area, or that could undermine the healing process.
When sleeping, it may help to have the head higher than the rest of your body.
To relieve pain, acetaminophen, such as paracetamol or Tylenol, can be used. Ibuprofen and aspirin are not suitable, as they reduce the blood's ability to clot. This can lead to further bleeding and bruising.
Medical treatment for a black eye
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.
This may be a neurosurgeon if a brain or skull injury is suspected, an ophthalmologist if there appears to be an injury to the eye, an ears, nose, and throat (ENT) specialist for a suspected face injury, or a plastic surgeon if there are serious cuts.
How to avoid a black eye
A number of measures can reduce the likelihood of traumatic injury, including a black eye.
At home, rugs and carpets should be well placed, without wrinkles that people can trip over. The stairs and floor should be clear of items, especially in areas where people walk.
During activities that increase the risk to the face, such as martial arts, boxing, and contact sports, protective gear should be worn. When cycling or riding a motorbike, a helmet must be worn.
Goggles can help if an activity could lead to a blow in the face, for example, when gardening, woodwork, or metalwork.
Car drivers and passengers must always wear a seat belt.