What causes a black eye?

A black eye, sometimes called a "shiner", results from a blow to the eye, nose, or forehead. Depending on where the blow lands, one or both eyes may be affected. A black eye is caused when blood and other fluids collect in the space around the eye. Other causes of black eye include:

  • Surgical procedures to the face, such as a  facelift, jaw surgery, or nose surgery; or
  • A certain type of head injury, called a basilar skull fracture, causes both eyes to swell and blacken.

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Initially, the swelling and discoloration may be mild. The area around the eye often starts off slightly reddened, and then progresses to a darker shade and swelling increases. Some blurry vision or difficulty opening the eye may occur, but more serious visual problems are less common. Over the course of a few days, the area becomes lighter and the swelling decreases.

When should I call the doctor for a black eye?

Most black eyes are minor injuries that heal on their own in a few days with ice and OTC pain medications, but some conditions require immediate medical care.

Get to an emergency department immediately in the following situations:

  • the patient experiences changes in or loss of vision (especially double vision);
  • an inability to move the eye itself (i.e. unable to look in different directions);
  • any injury in which an object may have pierced the eye or may be inside the eyeball;
  • if there is obvious blood in the eye itself;
  • if there is deformity to the eye;
  • fluid leaking from the eyeball;
  • if there are any lacerations (cuts) to the eye area, face, or head;
  • the patient has signs of a serious head or facial injury;
  • if the black eye is accompanied by broken bones or teeth;
  • loss of consciousness;
  • changes in behaviour;
  • nausea, vomiting and/or dizziness;
  • inability to walk;
  • blood or clear fluids coming out of the nose or the ears;
  • patients who take blood thinners, or those with a history of bleeding problems;
  • swelling after a bee sting near the eye; or
  • an eye infection is suspected.

What is the treatment for a black eye?

Home remedies for black eye include rest and ice applied early after the injury help to 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 every hour for the first 24 hours (a package of frozen vegetables such as peas or corn can be used as it will conform to the shape of the face better than ice cubes).
  • To avoid potential cold injury to the site, wrap the ice or frozen object in a cloth or use a commercial ice pack.
  • Do not use raw meat on a black eye as putting potentially bacteria-laden meat on a mucous membrane or an open skin injury can be dangerous.
  • Protect the injured area.
  • Avoid activities until after the eye has healed.

For more complicated injuries, the patient may be referred to an appropriate specialist, such as an ophthalmologist, who can treat the patient's injuries to the eye itself, or an otorhinolaryngologist (ear, nose, and throat [ENT]), or an oral/maxillofacial surgeon for fractures to the face.

Black eye injury can be avoided with basic injury prevention

  • Check the home for items that might cause a fall, such as throws, rugs or objects on the floor (such as toys).
  • Wear the appropriate protective gear for any athletic or work-related activity.
  • Wear goggles or other eye protection when working, doing yard work, or other hobbies and sports that may be injurious to the eyes.
  • Wear seat belts while driving and wear helmets when riding a motorcycle.

Sources:
http://www.medicinenet.com
https://nei.nih.gov

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