Treating a Black Eye

Black eyes are common among kids who play sports. A black eye often results from injury to the face, nose or head and is caused when blood and other fluids collect in the space around the eyes. Swelling and dark coloration result in the appearance of a “black eye” – The clinical term is periorbital hematoma sometimes called a “shiner”.

Because the facial skin around the eye socket is relatively thin and transparent, even a slight pooling of blood can result in a very noticeable discoloration. Also, since the tissue in this area is relatively loose, fluid leaking from blood vessels easily accumulates around the eye, resulting in a puffy black eye.


  • Use an ice pack for 10 minutes at a time, every hour for 24 hours, to reduce swelling, ease pain, and also narrows your blood vessels. That will stop bleeding below your skin. Use an over the counter pain medication, such as Tylenol, not Aspirin, it thins the blood.
  • If an ice pack is unavailable use a bag of frozen vegetables or ice cubes, wrapped in a soft cloth so the cold doesn’t damage the skin tissue. DO NOT USE RAW MEAT on a black eye. The bacteria on raw meat raises the risk of infection.
  • After a day or two gently apply warm-not hot compresses to the affected area. This will increase blood flow.
  • Avoid contact sports until the injury heals to avoid further injury.
  • If swelling and pain does not improve in a few days or worsens, see a doctor for treatment.

Other common causes of black eyes

  • Cosmetic surgery
  • Sinus infection
  • Nasal /nose surgery
  • Dental work or tooth infections
  • Cellulitis
  • Skull fracture

Call a doctor, get to an emergency department or dial 911 if the injured individual has changes in vision, severe pain, headache or swelling does not go away, the swelling around the eyes is not related to a known injury, there are signs of infection (for example fever, warmth, redness), pus-like drainage, fluid leaking from the eyeball, nose or ears, appearance of flashes of light, if the person has behavioral changes, forgetfulness, lethargy, nausea, vomiting, dizziness, loss of vision, double vision or an inability to move the eye itself (i.e. unable to look in different directions), any injury in which a sharp object may have pierced the eye or may be inside the eyeball, if there is obvious blood in the eye itself, a deformity to the eye, cuts to the eye area, head or face. If the injured has severe head or facial injury, if the black eye is accompanied by broken bones or teeth, loss of consciousness, or an inability to walk.

Patients who take blood thinners such as Coumadin or Warfarin, this is why no aspirin. Those with a history of bleeding problems like hemophilia.

Complications include traumatic iritis and uveitis, hyphema, glaucoma, orbital floor fracture (blowout fracture), and retinal detachment.

A black eye usually will disappear on its own. During the healing period, it is important to protect the eye from further damage by avoiding any activities where additional injury may occur.




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