A black eye is a bruise around the eye, forming when trauma causes tiny blood vessels beneath the skin to break. The thin skin around the eye socket makes even a small amount of pooled blood highly visible. While often a minor injury, proper care is important for healing and recognizing when medical attention is needed.
Immediate Steps for a Black Eye
Immediately after a black eye, minimize swelling and discoloration. Apply a cold compress initially; it constricts blood vessels to limit internal bleeding and fluid accumulation.
Wrap an ice pack or frozen vegetables in a clean cloth. Place this over the closed eye for 15 to 20 minutes. Avoid applying ice directly to skin, as it can cause cold injury. Repeat hourly for the first 24 to 48 hours to manage swelling. Elevating the head, especially while resting, also aids in reducing puffiness by allowing gravity to drain excess fluid.
At-Home Healing Strategies
After 24 to 48 hours, as swelling subsides, shift from cold to warm compresses. A warm (not hot) compress increases blood flow, promoting reabsorption and breakdown of pooled blood to clear discoloration.
Soak a clean cloth in warm water, wring it out, and apply for 20 minutes, several times daily. Gentle massage around the bruise (not on the eye) can stimulate the lymphatic system, assisting in clearing blood and reducing swelling. For discomfort, use over-the-counter pain relievers like acetaminophen or ibuprofen, but avoid aspirin as it can thin blood and worsen bruising. Avoid activities that could lead to further eye or face injury.
When to Consult a Doctor
Most black eyes resolve with home care, but certain signs indicate a more serious injury requiring immediate medical attention. Vision changes (blurriness, double vision, light sensitivity, or partial/complete loss) require prompt evaluation. Severe or persistent pain, especially if not improving after a few days, also warrants professional help.
Other concerning symptoms include inability to move the eye normally, blood in the white part of the eye (hyphema), or unequal pupil sizes. Signs of infection (increasing redness, warmth, pus-like drainage, or fever) also require medical consultation. If the injury involved a cut or laceration near the eye, a penetrating object, or bruising around both eyes (“raccoon eyes”), seek medical attention to rule out severe orbital or skull fractures.
What to Expect During Healing
A black eye heals through characteristic color changes as the body breaks down pooled blood. Initially, the area may appear red or deep purple, often with swelling.
Within days, as hemoglobin breaks down, the bruise may deepen to blue or black. Around days 5 to 10, it transitions to green and yellow, indicating further breakdown. The color then lightens to light brown or fades completely. Most black eyes heal within one to two weeks, though the timeline varies by severity. Swelling may temporarily worsen before improving, and discoloration can spread down the cheek due to gravity.