Doctor's Notes on Black Eye
A black eye refers to the visible bruising of the eyelid and the area around the eye. A black eye is typically caused by trauma to the eye or face. A common cause is a blow to the nose, eye, or forehead. Other causes can include surgery on the face or a type of skull fracture known as a basilar skull fracture.
Signs and symptoms associated with a black eye can include pain, swelling, and headache. The bruising is usually dark purple at the outset after the injury. Certain symptoms may be indicative of a more serious injury, such as severe pain, vision changes, changes in mental status, nausea and vomiting, dizziness, forgetfulness, behavioral changes, or inability to move the eye.
Black Eye Symptoms
Pain, swelling, and bruising are the most common signs and symptoms of a black eye.
- Initially, the swelling and discoloration may be mild. The eye may start off slightly reddened, then progress to a darker shade.
- Later, the skin around the eye becomes deep violet, yellow, green, or black in color.
- Swelling increases as discoloration progresses.
- Over the course of a few days, the area becomes lighter and the swelling decreases.
Although some blurry vision or difficulty opening the eye may occur because of the swelling, more serious visual problems are less common.
A headache may also be present because the usual cause of a black eye is some sort of head injury.
Signs of a more serious injury are:
- Double vision
- Loss of sight
- Loss of consciousness
- Inability to move the eye
- Blood or clear fluid from the nose or the ears
- Blood on the surface of the eye itself
- A persistent headache
Black Eye Causes
The most common cause of a black eye is a blow to the eye, forehead, or nose. Depending on where the blow lands, one or both eyes may be affected.
- A blow to the nose often causes both eyes to swell because the swelling from the nasal injury causes fluid to collect in the loose tissues of the eyelids.
- Surgical procedures to the face, such as a facelift, jaw surgery, or nose surgery, can cause black eyes.
- A certain type of head injury, called a basilar skull fracture, causes both eyes to swell and blacken. This condition is typically described as "raccoon's eyes."
- Other causes of swelling around the eye include allergic reactions, insect bites, cellulitis (skin infection around the eye), angioedema (a hereditary condition causing swelling, usually around both eyes), and dental infections. However, these conditions do not make the skin turn black and blue around the eye.
You bump your leg against the coffee table. You drop something on your toe. You take a spill on the sidewalk while walking the dog. All of these situations may result in a bruise. A bruise happens when small blood vessels underneath the skin become injured and leak blood. This results in a colorful mark under your skin known as a bruise. Bruises may also occur due to certain medical conditions or as a side effect of some medications or treatments. Warfarin is one of several medications associated with excess bruising. It is an anticoagulant medication. Most bruises that are minor injuries heal within approximately 2 weeks. Soft tissues, muscles, and bones may be injured by bruising.
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.