Black eye is a phrase used to describe bruising around the eye due to an injury to the face or the head. Blood and other fluids collect in the space around the eye, causing swelling and dark bruising in the tissue.
When there is trauma or injury to the face, the skin around the eye — which is very loose — is one of the first places to swell as fluid builds up. Although the name "black eye" would indicate otherwise, the eye itself is usually not injured. Many black eyes heal on their own in a few days.
However, a black eye can be a sign of a more serious injury. For instance, if there is bleeding within the eye that is called a hyphema and should be looked for any time you see a black eye. It can affect your cornea and your vision. In some cases of face or eye trauma, increased pressure inside the eyeball can occur, resulting in damage to the eye and eyesight if not treated. If both eyes are black after a head injury, it could signify a skull fracture or other serious injury.
What Are Symptoms of a Black Eye?
After an injury to the eye, it is important to distinguish between symptoms of black eye and those that might indicate a more serious head injury.
Black eye symptoms may include:
- pain around the eye
- swelling around the eye, which can be mild at first, then increasing later. Swelling may make it difficult to open the eye
- discoloration (like a bruise) around the eye. The skin around the eye may be red at first, then grows darker, progressing to purple, yellow, green or black
- blurred vision
Signs of a more serious head injury require medical attention, and may include the following:
- double vision
- vision loss
- blood on the eyeball surface
- inability to move the eye
- severe or ongoing headache
- fainting/loss of consciousness
- blood or fluid coming from the ears or nose
What Causes a Black Eye?
A black eye is most commonly caused by something hitting the eye or nose. Either one or both eyes may be blackened depending on where you get hit. If you suffer a blow to the nose, both eyes may swell; the swelling is due to the buildup of fluid in the loose skin beneath the eyes. Other types of trauma to the head can cause black eyes, including skull fractures.
Facial surgery can also cause black and swollen eyes, including facelifts, nose surgery or surgery on the jaw. Other conditions, such as allergies and infections, can lead to swelling around the eye, but not the bruising discoloration of a black eye.
Black Eye Diagnosis
In general, your doctor can simply do a physical exam to diagnose a black eye. He or she will check your vision and test the motion of your eye by moving his or her finger in front of your face and asking you to follow the movement with your eyes. The doctor will shine a light into your eyes to assess if your pupil is dilating normally and to look at the inside of your eye for any problems.
The doctor will also examine the bones in your face and around your eye. If he or she suspects you may have fractured any bones or that there might be something inside the eye, you may have an X-ray or CT scan.
Black Eye Treatment
A typical black eye that does not involve more serious symptoms is generally treated with self-care at home. To reduce swelling and ease pain the first day, an ice pack can be applied to the eye for 15-20 minutes at a time, once every hour. If an ice pack is not available, a bag of frozen vegetables can be used, or ice cubes wrapped in cloth (to avoid freezing the skin). Despite what you see in movies or on television, you should never put a raw steak or other raw meat on a black eye. The bacteria on raw meat poses a high risk of infection, and this method of treating a black eye has no scientific basis.
Finally, be sure to keep the affected eye(s) well-protected from further injury. Avoid sports or other similar activities where the eye can be hit until the eye has healed.
If pain or swelling from a black eye do not improve after a few days, or if you are experiencing vision changes or problems, call your ophthalmologist.