A black eye, medically known as a periorbital hematoma, is a bruise around the eye. It results from trauma to the face or eye area, causing blood vessels to break and leak. This leads to characteristic discoloration and swelling. While the name suggests an eye injury, a black eye refers to bruising of the skin and tissues surrounding the eye, not the eyeball itself.
Immediate Care and Home Remedies
Upon sustaining a black eye, immediate action can reduce swelling and discomfort. Apply a cold compress to the affected area within the first 24 to 48 hours. This constricts blood vessels, minimizing leakage and reducing swelling. Gently place a cold pack, crushed ice, or frozen vegetables wrapped in a thin cloth over the closed eye for 15 to 20 minutes at a time, repeating hourly. Avoid direct contact of ice with the skin to prevent damage, and never use raw meat, as it can introduce bacteria and lead to infection.
After 48 hours, once initial swelling subsides, switch to a warm compress to promote healing. Apply a warm (not hot) compress for 20 minutes at a time, several times daily. This increases blood flow, aiding in the reabsorption of pooled blood.
Keep the head elevated, especially while sleeping, to reduce fluid accumulation and swelling. Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can manage pain. Avoid aspirin, as it thins blood and can worsen bruising. Throughout healing, use gentle care around the eye, avoiding pressure or rubbing.
Understanding the Healing Process
A black eye progresses through color changes as it heals, reflecting the body’s process of breaking down and reabsorbing blood. Initially, the skin around the eye may appear reddish, quickly progressing to deep purple, blue, or black within one to two days due to blood pooling. This discoloration occurs as hemoglobin, the protein in red blood cells, begins to break down.
Between days two and ten, the bruise transitions to greenish and yellowish hues. These color shifts indicate further breakdown of hemoglobin into compounds like biliverdin and bilirubin. As healing continues, between days ten and fourteen, the bruise will appear yellowish or light brown before fading. Most black eyes resolve completely within two to three weeks, though the timeline can vary depending on injury severity, age, and overall health.
When to Seek Medical Attention
While most black eyes are minor injuries healing with home care, certain symptoms indicate a more serious underlying condition requiring immediate medical evaluation. Seek prompt medical attention if you experience vision changes, such as blurred vision, double vision, or vision loss. Persistent or severe pain, inability to move the eye normally, or blood visible in the white or colored part of the eye are also concerning signs.
Other red flags include unequal pupil size, a persistent headache, dizziness, nausea, or vomiting. Signs of infection, such as increased redness, warmth, pus, or fever around the eye, warrant a doctor’s visit. If the black eye resulted from a significant head injury, if bruising appears around both eyes (“raccoon eyes”), or if there’s a suspected broken bone around the eye or nose, professional medical assessment is needed. These symptoms could indicate an orbital fracture or other serious internal damage.