A black eye is the appearance of bruising around the eyes. It’s usually the
result of trauma to the head or face, which causes bleeding beneath the skin.
When the small blood vessels, or capillaries, beneath the skin break, blood
leaks into the surrounding tissue. This is what causes the discoloration or
Most black eyes aren’t serious but can sometimes can be an indicator of a
medical emergency such as a skull fracture. Black eye is also referred to as
eye bruises and bruising around the eyes.
Black eyes can appear after some surgical procedures, such as nose surgery
or a facelift. A black eye may occur when blood, originating in the forehead or
nose, settles by gravity under the eye. "Raccoon eyes" refers to
blood that settles under 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 bruises around
the eyes fades to yellow or green. That’s because the blood under the skin eventually
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 in someone you know may
be a sign of domestic violence or abuse. Your health providers are required by
law to ask questions to make sure you’re safe in your domestic situation.
If you seek medical treatment for a black eye, your doctor will perform a
basic examination. They’ll also ask how the injury occurred and inquire about
related injuries. Your doctor will test your vision by shining a light into
your eyes and will also ask you to follow their finger with your eyes.
If a skull fracture is suspected, you will have a CT scan and X-ray of your face
and head. If an eye injury is suspected, you’ll be referred to an
ophthalmologist. The specialist may put a dye in your eye to test for eyeball
If a head injury is suspected, you will be referred to a neurosurgeon. If
fractures of the face are suspected, you’ll be referred to an ENT specialist.
Conditions that are likely associated with a black eye include:
- broken nose
- dengue fever
- hemophilia A
- hemophilia B
- epidural hematoma
- eye emergencies
- head injury
- factor II deficiency
- factor V deficiency
- factor VII deficiency
- factor X deficiency
- shaken baby syndrome
- skull fracture
- subdural hematoma
- von Willebrand disease
Black eyes due to a minor injury can be treated with ice, rest, and pain
medication. A follow-up visit with your doctor will be suggested if you have
any visual changes or lingering pain. If swelling and pain accompany the bruising,
apply a cold compress for 20 minutes, then take it off for 20 minutes. When the
swelling reduces, you may apply a warm compress to help promote the reabsorption
For any pain and throbbing, you may take pain relievers such as ibuprofen or
acetaminophen. Avoid putting pressure on the affected area.
There are many home remedies you can use to treat a black eye. An ice pack is
the best method. Sometimes people use frozen packs of raw meat. It’s best to avoid
this, as the meat may contain harmful bacteria.
Arnica is a good herbal remedy to reduce swelling. Another option is to mix 5
tablespoons of melted Vaseline with cayenne pepper to make a natural healing
ointment. But careful with this homemade remedy. The ointment can burn the
eyeball if the two come in contact. Vitamins C and K will also promote healing
and reduce swelling.
Black eye in
children and toddlers
Small children will need a cold compress placed on their eye for 15 minutes
at a time throughout the day. They may also be required to wear an eye shield
because swelling can force the eye shut.
At home, hold your child’s head higher than their heart for a day or two.
Try to keep them from being too active. Also, keep your child from rubbing
When to seek
immediate medical treatment
Black eyes are accompanied by an assortment of symptoms that could require
A black eye may be the repercussion of a facial fracture. You need to seek
immediate medical attention for any broken bones on your face or skull.
If headaches persist or if you experience a loss of vision or consciousness,
your black eye may be a symptom of a concussion or a fracture. Other symptoms
of a concussion include:
- memory lapses
Another serious concern is the draining of blood or clear fluid from your nose
or ear. Blood on the surface of your eyeball is also a cause for concern. This
can be a sign of a ruptured eyeball or of damaged blood vessels in the eye.
This may cause additional swelling and infection, which can make your eye
immobile and blur your vision.
Sometimes black eyes can occur without trauma affecting the eye. If you have
bad nasal allergies, you can get “allergic shiners.” These shiners may cause
dark circles or the appearance of a black eye because blood flow is slightly
hindered. The small veins under your eye will pool with blood and enlarge
because the blood is going back to your heart more slowly.
Although highly unlikely, a black eye in a child without any sign of trauma
can be an early symptom of myeloid leukemia.
Most cases of black eye can be treated at home with ice, rest, and pain
relievers. A black eye can last anywhere from one to two weeks as the bruising
heals and blood slowly is absorbed back into your skin.
Things to avoid while recovering from a black eye are:
- applying too much pressure
- putting heat on the affected area
- playing sports or being overly active in a way that will
set you up for further injury