Symptom: Black Eye

    Black Eye Overview

    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 appear after some surgical procedures such as nose surgery or facelift. 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 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

    Associated diagnoses include:

  • broken nose
  • concussion
  • Dengue fever
  • Christmas disease
  • epidural hematoma
  • eye emergencies
  • head injury
  • factor II deficiency
  • factor V deficiency
  • factor VII deficiency
  • factor X deficiency
  • subdural hematoma
  • shaken baby syndrome
  • skull fracture
  • hemophila A
  • Von Willebrand disease
  • Diagnosis and Treatment

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

    If you seek medical treatment, a thorough physical examination will be done, including an eye exam. CT scans and x-rays of the face and head may be done if fractures are suspected. If an injury to the eye itself is suspected, you will be referred to an ophthalmologist. 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. You will be referred to a cosmetic surgeon to repair any significant lacerations of the face.

    When to Seek Immediate Medical Treatment

    Black eyes are accompanied by any of the following symptoms:

  • fractures
  • broken teeth
  • headache
  • loss of vision
  • loss of consciousness
  • blood or clear fluid draining from the nose or ears
  • blood on the surface of the eyeball
  • inability to move the eye
  • blurred or otherwise altered vision
  • red eyes
  • purulent drainage
  • behavioral changes: forgetfulness, lethargy
  • nausea, vomiting, or dizziness
  • gait changes or difficulty walking
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    Signs and Symptoms

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