The black eye is called so due to the fact that there is bluish or blackish discoloration following a bruise. Read this article to know more about this condition.
The eye is one of the important parts of the body that helps us see. The skin surrounding the eye is usually of normal color, but sometimes, there can be some discoloration which can be physiologic or pathologic. This article explains about one such condition that is the black eye. This happens when there is a presence of any bruising under the skin that surrounds the eye.
Another term used to describe this condition is “Shiner,” which is medically termed a periorbital hematoma. It is also called raccoon eyes. As in this situation, the blood can be seen settling under the eyes and is mostly in conjunction with skull base fracture.
A black eye, which is due to bruising, most commonly happens due to any injury to the head or face, which in turn leads to bleeding in the tissues within the skin. This is due to the breakage of small blood vessels or capillaries that are present beneath the skin. Most of such conditions are not serious, but a medical examination should be carried out as this can be caused secondary to any emergency situation like a fracture of the skull.
Sometimes, it may also be seen developing post-surgery like in cases of surgery of the nose, facelift surgeries, etc. The discoloration tends to change into yellow or green depending upon the healing because of the breaking down of blood and reabsorption into the tissues that surround it. It may require almost two weeks to heal or come back to its normal color, depending upon the amount of blood collected. It is important to examine and be aware of black eyes caused due to unexplained reasons as this can be a sign of domestic violence or any abuse.
It is important to know when to call your doctor. It is important to contact your physician in case the individual has vision changes after injury or experiences extreme pain or constant swelling, signs of infection like warmth, fever, redness, malaise, drainage of pus-like material, etc. Also, if the individual has any change in behavior, forgets easily or is lethargic, experiences nausea and vomiting, difficulty in moving the eyeball, requires immediate medical attention.
Initially, on visiting the physician, he or she will question you about your basic details followed by the details of the injury like how and when it occurred, etc. Then, your vision will be tested by
using light, and you will be asked to follow the doctor’s finger with your eyes.
If the physician suspects a fracture of the skull, you will be asked to undergo a CT (computed tomography) scan and X-ray of your head and face. For a suspected eye injury, you will be asked to consult an eye specialist or ophthalmologist. The eye specialist will put a dye in the eyes to test for any abrasion in the eyeballs. For head injury, referral to a neurosurgeon will be done, and for facial fractures, ENT (ear, nose, and throat) specialists will be asked to check for it.
Yes, many conditions suspected to be associated with black eyes are mentioned below:
2. Injury to the nose.
3. Dengue fever.
4. Emergency conditions of the eyes.
6. Factor II, V, VII, X deficiency.
7. Fracture of the skull.
8. Injury to the head.
9. Subdural hematoma.
10. Von Willebrand disease.
Hence, while examining and providing a diagnosis for a black eye, it is important to check for the above-mentioned conditions too so that proper diagnosis can be made and better treatment can be done.
The management of the black eye is usually conservative. In minor cases where the black eye is due to a minor injury, the application of ice along with rest and pain medication proves beneficial. If there is any continuous pain or changes in the vision, a follow-up may be required.
In case of the presence of swelling and pain along with bruising, initially cold compress can be applied for 20 minutes, and after the reduction of swelling, a warm compress can be applied to aid in promoting the blood reabsorption from beneath the skin surrounding the eyes.
For managing pain along with throbbing sensation, pain relievers like Ibuprofen or Paracetamol can be used. It is advisable to avoid any application of pressure on the affected side.
Some home remedies can prove to be helpful, but still, scientific evidence is lacking in this field. Some of the home remedies include Arnica, ice pack, vitamins C and K, etc.
In the case of children and toddlers, a cold compress application can be made for 15 minutes every time throughout the day. They should also be advised to wear an eye shield as the eye swelling can lead to the closing of the eyes.
In case you experience symptoms like nausea, vomiting, lethargy, dizziness, memory lapses, any blood or clear fluid drainage from the nose or ear, etc., along with black eyes, it is advisable to contact your physician immediately.
Initially, ice application should be made in the affected area without pressing the eye. Pain can be managed using medications like Paracetamol, Ibuprofen, etc. Call for medical help if there are any vision changes, severe pain, eye injury, or any of the above-mentioned complications. Regular follow-up is necessary till it heals.
Black eyes can be mild to severe depending on various factors and need medical attention and care to prevent eye complications and worsening vision. In order to get detailed information on the black eye, you can now contact a physician or specialist at the ease of your home through online medical platforms.
The black eye generally heals within two to three weeks. The healing time depends on the age and physical status of the patient, the severity of the injury, and the type of treatment. Application of ice packs and taking pain medications have proven helpful in treating black eyes caused by minor injuries.
The factors that help in quick recovery are as follows:
The application of ice for 10 minutes every one to two hours will reduce the swelling and bleeding under the skin.
Gentle pressure: Avoid giving excessive pressure on the black eye while giving cold compresses.
Lift the head position at times apart from sleep to direct the blood flow to the heart and avoid blood build-up near the eye.
Avoid further injury: Stay at home or avoid activities that pose a risk to an eye injury.
The severity of the black eye is not judged by viewing the eye in the mirror. The features that indicate a severe black eye are as follows:
- Bleeding or drainage from nose, ears, and eyes.
- Nausea and vomiting.
- Blurred or double vision.
- Loss of consciousness.
The eye color varies from one person to another and is inherited from our parents. The melanin and lipochrome pigments decide the eye color. The rarest eye colors are:
- Red or violet eyes can occur due to a condition called albinism characterized by the absence of melanin pigment.
- Blue and green eyes are found in 3 % of the population.
- Hazel or brown eyes are more frequent and happen due to increased concentration of melanin pigment.
The iris forms the colored portion of the eye. The partial or complete absence of the iris is referred to as aniridia. Since the iris tissue is small, the pupil looks large, giving the black eye appearance. The clinical features are increased sensitivity to light (photosensitivity) and vision changes.
After two days of injury, the swelling in the black eyes increases. It looks worse overnight, but it takes two weeks to heal completely. Initially, the bruising appears red due to the pooling of blood at the injury site. Then the color changes to purple as the oxygen level in the pooled blood decreases. After five to ten days, the skin around the injury looks green to yellow as the body mechanism breaks down the pooled blood. After 14 to 15 days, the color decreases or disappears.
The black eye generally requires two weeks to go away, and it also depends on the age and health status of the patient. Gentle pressure with ice within one or two days after the injury limits the blood flow and reduces the swelling and pain.
Waking up with a black eye is a sign of a previous hit or trauma and surgical procedure of the face. Rarely, nasal congestion caused by various allergens can also give a bruise-like appearance under the eye.
It is difficult to cover up the black eye as the color looks intense with days. The following measures are done.
- Gentle massage with ice packs for 10 to 15 minutes every hour. As the swelling reduces, a warm compress is given.
- Use of sunglasses to mask the black eye.
- Wearing caps also hides the black eye to some extent.
- Home remedies like oral intake of the herb Arnica vitamin C and K supplements will improve the healing process.
There is no need to worry if the black eye heals within two weeks with ice application and over-the-counter medications. However, immediate consultation with the doctor is essential if you have:
- Eye pain.
- Vision changes.
- Nausea, vomiting.
- Difficulty in eye movements, etc.
The common cause of black eye includes trauma to the head and face or following surgery in the facial region. The severe trauma to the head can elevate the blood pressure in the eye. It affects the optic nerve and damages the retina's blood vessels, and causes bleeding in the eyes.
The management of black eye are as follows:
- Minor injury: Application of ice over-the-counter painkillers like Paracetamol, Ibuprofen are essential.
- If swelling and bruising are present, a cold compress followed by a warm compress is given to reduce the swelling.
- Eye shields can be worn as a protective measure.
- Supplements like Arnica herb, Vitamin C, and K can heal the bruises.
An allergic infection can cause congestion of the sinus. It leads to the pooling of blood under the skin of the eye and dilation of veins. It is referred to as allergic shiners. It gives an appearance of bruises and puffiness under the eye.
The non-transparent lens looks good for black eyes. The lens is available in variable colors like green, blue, hazel, etc. The lens with increased opacity is used to show different colors of the iris in the case of a black eye.
Last reviewed at:
17 Mar 2022 - 4 min read
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