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What causes black eye? 19 possible conditions

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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See a list of possible causes in order from the most common to the least.


Broken Nose

This condition is considered a medical emergency. Urgent care may be required.

A broken nose is a break or crack in the bone or cartilage in your nose. These breaks often occur over the bridge of the nose or in the septum.

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Nose Injury

Nosebleeds are common and rarely indicate a serious medical problem. However, frequent nosebleeds, a bleed that lasts longer than 20 minutes or occurs after an injury may require medical attention.

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This condition is considered a medical emergency. Urgent care may be required.

A concussion is a mild traumatic brain injury. Usually it occurs after an impact to your head or after a whiplash-type injury. A concussion can cause many severe symptoms that affect brain function.

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Head Injury

This condition is considered a medical emergency. Urgent care may be required.

A head injury could be an injury to the brain, skull, or scalp. It can vary in severity depending on the cause. In some cases face swelling can be a sign of a head injury.

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Skull Fractures

This condition is considered a medical emergency. Urgent care may be required.

A skull fracture is any break in the cranial bone, or the skull. It can result in bleeding, bruising, pain, and swelling. Less severe symptoms include headache, nausea, confusion, and blurred vision.

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Eye Emergencies

This condition is considered a medical emergency. Urgent care may be required.

An eye emergency is when chemicals or a foreign object gets in the eye, or an injury affects the eye area. Emergencies require immediate medical attention to help prevent permanent vision damage.

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Epidural Hematoma

This condition is considered a medical emergency. Urgent care may be required.

An epidural hematoma occurs when blood fills the area between the skull and the protective covering of the brain. It usually results from a traumatic injury to the head, and puts you at risk for brain damage or death.

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Subdural Hematoma

This condition is considered a medical emergency. Urgent care may be required.

A subdural hematoma occurs when blood collects on your brain's surface beneath the skull. They usually result from a head injury.

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Hemophilia A

Hemophilia A (factor VIII deficiency) is the most common form of the blood clotting disorder hemophilia. It can cause prolonged bleeding, tight joints, and unexplained bruising.

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Foreign Object in the Eye

A foreign object in the eye is anything that enters the eye from outside the body and does not belong there. It causes immediate symptoms, but may or may not be serious, depending on the object.

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Factor V Deficiency

Factor V deficiency is a very rare blood clotting disorder that results in slow or prolonged blood clotting after an injury or surgery.

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Von Willebrand Disease

Von Willebrand disease is a rare bleeding disorder caused by a deficiency of von Willebrand factor (VWF), which helps blood clot. Symptoms include excessive nose bleeds and easy bruising.

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Shaken Baby Syndrome

This condition is considered a medical emergency. Urgent care may be required.

Shaken baby syndrome is caused by forcefully and violently shaking a baby. Other names for this condition include abusive head trauma, shaken impact syndrome, whiplash shake syndrome, and inflicted head injury. Shake...

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Factor II Deficiency

Factor II deficiency is a very rare blood clotting disorder caused by a lack of prothrombin, a protein that helps blood clot. Severe cases may cause unexplained bruising, bleeding gums, and nosebleeds.

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Ebola Virus and Disease

This condition is considered a medical emergency. Urgent care may be required.

Ebola disease is a rare, often fatal illness. One of its late-stage symptoms is a bleeding rash over the entire body.

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Christmas Disease (Hemophilia B)

Also called hemophilia B or factor IX hemophilia, Christmas disease is a rare genetic disorder in which your blood does not clot properly. A common symptom is unexplained or excessive bruising.

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Factor X Deficiency

Factor X deficiency, also called Stuart-Prower factor deficiency, is a condition caused by not having enough of the protein known as factor X (ten) in your blood. A common symptom is easy bruising.

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Dengue Fever

Dengue fever is a disease that affects much of the tropical region and is caused by one of four dengue viruses. A skin rash between two and five days after the initial fever is a common symptom.

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Factor VII Deficiency

Factor VII deficiency is a blood clotting disorder due to a deficiency in factor VII, a protein produced in the liver. It can cause bruising and soft tissue bleeding.

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This feature is for informational purposes only and should not be used to diagnose.
Please consult a healthcare professional if you have health concerns.