Black Eye from an Eye Injury

Dr. Russel Lazarus, July 28, 2021

Have you ever been hit in the eye? If so, you know that a black eye is often inevitable.

A black eye, often referred to as a ‘shiner’, is a bruise that commonly develops following a blunt blow to the delicate tissue around the eye.

After the blunt force injury, blood vessels burst and collect under the skin, especially in the area of the lower lid, due to the force of the blow. Since the skin around the eye is thin, it’s easy to see the ruptured vessels – which produces the dark red or black color.

What causes a black eye?

A black eye usually results from a head or facial injury that produces bleeding beneath the skin. Blood seeps into the surrounding tissue when the small blood vessels beneath the skin (capillaries) rupture. This is what produces the bruising and discoloration.

Although most black eyes aren’t significant, they can occasionally signal a medical emergency, such as a skull fracture or fractured facial bones.

Blood that collects under the eyes due to a fracture in the base of the skull is referred to as ‘raccoon eyes.’

Some facial surgical treatments, such as nose surgery or a facelift, can also result in black eyes.

Signs and symptoms of a black eye

Very soon after an eye injury, the eyelids and surrounding soft tissues begin to swell and turn a purplish-red to black color.

A subconjunctival hemorrhage, or minor rupture in one of the blood vessels beneath the conjunctiva, can cause the white of the eye to turn bright red. The tissues may swell considerably and the area around the bruising may be discolored.

The most signs and symptoms of a black eye may include:

  • Dark red-purple coloration under the skin around the eye
  • Blood spots or pooling on the sclera (the white of the eye)
  • Swelling of eyelids or tissue adjacent to the eyes
  • Blurry vision
  • Double vision
  • Flashes of light
  • Showers of black spots
  • Difficulty opening or moving the eye
  • Pain around the eye
  • Numbness on the injured side of the face
  • Loss of consciousness, nausea, vomiting or disorientation
  • Affected eye appears sunk into its socket

SEE RELATED: What to do for a Black Eye?

Consult an eye doctor near you if you’re experiencing any of the above symptoms, as they can signal an eye emergency.

Find an eye doctor near you

How long does a black eye last?

A black eye can last from a few days to up to two weeks.

During this time, the blood will be reabsorbed back into your skin and the discoloration around your eye will begin to fade.

Complications of a black eye

A black eye is usually a mild condition that only requires application of cold packs of ice or something softer such as frozen steak or vegetables.

Severe injuries, particularly physical damage to the eye, can lead to sight-threatening problems.

If any of the following are noticed, urgent medical care is required.

  1. Uveitis

Blunt trauma to the eye can cause internal damage to eye, such as traumatic uveitis and iritis (iritis is a form of uveitis). Iritis usually only affects one eye.

The first sign of uveitis or iritis could be a black eye, but then the signs below could appear;

  • Small or irregularly shaped pupil
  • Blurred vision
  • Floating spots before the eyes
  • Pain that increases with exposure to bright light
  • Reddened eye, especially around the iris
  1. Hyphema

Hyphema requires urgent medical attention.

This is a collection of blood inside the eye, in the front (anterior) chamber of the eye, which indicates damage to the eye’s internal tissues.

The amount of blood may be too little to notice with the naked eye, or it may completely fill the front of the eye.

  1. Glaucoma

Glaucoma is increased pressure inside the eye and may also be a result from blunt trauma to the eye, the increased pressure can occur immediately or even many years later.

The force of the trauma might produce internal bleeding, resulting in a rise in eye pressure and permanent damage to the optic nerve.

Even many years after the injury, scar tissue inside the eye can develop causing a slow rise in eye pressure and delayed-onset glaucoma might develop.

Glaucoma can cause permanent vision loss, known as ‘Tunnel Vision’.

  1. Orbital floor fracture

This is also known as a blowout fracture and may occur as a result of a forceful blunt trauma to the eye.

The force of the blow pushes the eyeball farther into the eye socket, breaking the eye socket’s very thin bone walls. The optic nerve and the muscles that move the eye can be pinched (entrapped) as a result.

An orbital floor fracture can cause double vision or loss of vision which needs urgent medical care.

  1. Retinal detachment

Detachment of the retina can result in permanent vision loss.

Trauma to the eye can cause the retina, which lines the back of the eyeball, to be lifted or pulled out of its usual position, causing the detachment.

Flashing lights, partial or complete vision loss in the eye, and spots/floaters in the field of vision are all symptoms that must be treated immediately.

How is a black eye treated?

The best remedies for any swelling or bruising on the body include ice, rest and pain medication.

If you experience any vision changes or persistent pain, immediately schedule an appointment with your eye doctor or seek emergency medical attention.

If the bruising is accompanied by swelling and pain, use a cold compress for 10-20 minutes, then remove it for a few minutes before reapplying.

Arnica may be recommended as an effective herbal treatment for swelling reduction. Vitamins C and K can assist in the healing process and help to minimize swelling.

LEARN MORE: Guide to Eye Health

If you’ve suffered a blunt force injury causing a black eye, contact an eye doctor near you. 

A black eye needs to be examined by an eye doctor – it might only need a frozen pack of peas or could be a serious sight threatening eye injury.