Team AckoJun 9, 2023
Black Eye looks exactly what it sounds like. It refers to the blackening of the skin around the eyes following any injury or trauma such as a nasty fall or a punch in the face. This type of bruising indicates the pooling of blood. Hence, it is medically termed a periorbital hematoma. Most of the time it resolves by itself; however, it may at times be an indication of a more significant underlying trauma that requires medical intervention.
The eyeball is situated in a pocket of the skull called the eye socket, which encloses the eye with its supporting structures. The eye socket is a relatively free bony cavity, mainly containing loose connective tissue and some fat, which protects the eyeball and yet allows it to move freely.
When there is any trauma or blunt injury to the head or the face, the small blood vessels supplying that area are damaged and bleeding occurs. This blood then collects in the only area where it finds space: the socket surrounding the eyes. From the outside, this looks like a dark bruise around the eye.
Black Eyes are also seen as finding following fractures in the base of the skull. This typically leads to the pooling of blood around both eyes and has been termed “raccoon eyes”.
A Black Eye can also occur following surgery to the head and face, especially over the forehead or nose. This is commonly seen in plastic surgery procedures of the face like facelifts and nose jobs (rhinoplasty), as well as following surgery to correct fractures of the skull following trauma. In this case, the bruising is usually seen in the immediate postoperative period.
Typically, a Black Eye does not refer to bleeding within the eyeball; the eye is usually uninjured in the situation. If there is bleeding within the eyeball, this condition is called hyphema. It presents very differently from a Black Eye as it is due to a direct injury to the eyeball resulting in loss or decrease in vision.
This is a significantly more serious condition that requires the intervention of an ophthalmologist, as it can cause an increase in pressure inside the eyeball, damage to parts of the eye like the cornea & iris, and permanent loss of vision.
A Black Eye occurs following any sort of injury or blunt force trauma to the face or head. Most of the time it occurs surrounding only one eye.
It appears as a dark, purplish-blue-black discolouration mainly underneath the eye.
It is usually associated with swelling of the area surrounding the eye, which can cause difficulty in opening the eyelid.
There may be pain around the eye.
It may be accompanied by some blurring of vision in that eye.
A Black Eye associated with the following presentations is indicative of a more serious injury:
Black Eyes around both eyes (also referred to as raccoon eye) is a sign of skull bone fracture/more extensive injury
Loss of vision/sudden blackening of vision
Nausea & vomiting
Drowsiness, altered mentation, and loss of consciousness are all indicative of neurological impairment
Drainage of fluid through the nose or ears (this can be clear fluid as well as blood)
The above-mentioned features occur due to more severe trauma to the face or head. These are indicative of injury to the more sensitive structures of the skull and even underlying organs. They require immediate attention from a medical professional so that the underlying problem can be rectified before it worsens.
It is always advised to see a doctor if you have suffered any injury to the head or face because this region houses many sensitive, vital structures.
A Black Eye is a clinical diagnosis. Your doctor, after a thorough history and examination, will usually be able to assess the severity of the injury. They will usually check the region of the swelling, the integrity of the eyeball and its components, vision, movements of the eyeball, the response of the pupils to light, etc.
They may order some scans (x-ray, CT, MRI) of the facial bones, eye socket (or orbit), and if required also of the brain to look for fractures, internal bleeding, and other signs of injury that may require hospitalisation and/or surgical treatment.
If you are on any blood thinners, make sure to inform your doctor of the same at the time of diagnosis. Giving them all details about your health prior to this incident will be useful in formulating an appropriate treatment plan for you.
The good news is that in a vast majority of cases, you do not need to do anything for a Black Eye. The condition will resolve by itself. The colour of the bruise will gradually change over a few days from black or blue to green or yellow. Eventually, that too will fade away.
In the period immediately following the injury, a few simple steps can help relieve the pain and swelling. It is important to take rest, apply cold compresses, and take painkillers as required. You can soak a clean cloth or a sterile gauze piece in cool water and apply it over the eyes for 15 to 20 minutes.
A cold compress can also be applied by wrapping an ice pack or ice cubes or any cold object from a freezer in a clean piece of cloth and placing it over the injury with a minimal amount of pressure for at least 8 to 10 minutes. Doing this helps control the swelling, arrests any bleeding happening locally, and provides pain relief. This is recommended as soon as possible following injury, with several repetitions over the course of the day.
Once the initial swelling has resolved, warm compresses can be helpful in aiding the healing of the Black Eye. Make sure to avoid using hot water as it can cause burns.
Make sure to assess if the consciousness level of the person is normal. Any disorientation/drowsiness/loss of consciousness/fits are indicative of neurological damage which require urgent care.
Check if there is any active bleeding from any site of injury. Look for any fluid discharge from the nose and ears.
Check to see if there is any bleeding inside the eyeball. Ask for any change in vision, double vision, or loss of vision. Check for free, painless movement of the eyeball in all directions possible.
Look for any apparent swelling in other parts of the face or head.
Do not apply pressure directly on the eyeball.
Vitamin C and K have been found to aid healing.
Cool compresses are the best option in the initial period following injury. Later, warm compresses can be used. However, using hot water bottles or heating pads directly on the face should be avoided.
A Black Eye heals over 10 to 14 days. The colour gradually fades from black to blue to green or yellow, eventually leaving behind a light brown patch that resolves over a few days.
If your Black Eye does not subside within 2 to 3 days, worsens in size and intensity of pain, or begins to affect both eyes and vision, consult a doctor immediately.
Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. Please consult a doctor before making any health-related decisions.
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