Black Eye

Overview

A black eye is bruising around the eye, usually caused by a blow to the face. The skin looks purple, blue, or black because small blood vessels under the skin have broken and leaked blood. The area may also be swollen and tender.

Yes. Black eyes are very common. They happen often after minor falls, sports injuries, or trips and bumps.

Anyone can get a black eye. They are especially common in children, athletes, and older adults who are more likely to fall.

Symptoms

Common symptoms

• Swelling around the eye
• Bruising that starts red or purple and then changes to blue, green, or yellow
• Mild pain or tenderness when touching the area
• A dull ache or headache

Symptoms in children

• Swelling can be worse in children because their skin is stretchy.
• Children may have trouble opening the eye if the swelling is severe.
• They may be upset or cry because the area feels sore.

Symptoms in older adults

• Older adults bruise more easily because their blood vessels are more fragile.
• Swelling and bruising may spread further around the eye and face.
• If the black eye came from a fall, it is important to check for a head injury as well.

Causes

Main causes

• A direct blow to the eye or the bones around it, such as a punch, an elbow, or a ball hitting the face
• Falls onto the face, which is common in children and older adults
• Accidents while doing sports or physical activities
• Injury to the nose or forehead that causes swelling to travel down to the eye area
• Recent surgery on the face, such as eye surgery, facelift, or nose surgery

Risk factors

• Playing contact sports such as boxing, football, or rugby
• Not wearing protective eye goggles or a helmet during risky activities
• Having a condition that makes you bleed or bruise more easily
• Taking medicines that thin the blood or affect clotting
• Having balance problems or poor eyesight that increases your risk of falls

When to see a doctor

See a doctor urgently if:

• If you lose your vision, see double, or have very severe eye pain
• If the eye itself appears damaged or you see blood inside the eye
• If you have a headache that is getting worse, feel sick, or are unusually drowsy
• If you have weakness in any part of your body or difficulty speaking
• If you have bruising around both eyes after a head injury

Book a routine appointment if:

• If the swelling does not improve after a few days
• If you are worried about the injury or do not know if your eye is safe
• If you have blurred vision that lasts longer than a day
• If you have a medical condition that affects your eyes or your ability to heal

Diagnosis

A doctor or nurse will ask how the injury happened and then examine your eye. They will check your vision, how your pupil responds to light, and whether you can move your eye fully in all directions. They will also feel around the bones of your eye socket for tenderness.

Tests that may be done

• Usually no tests are needed for a simple black eye.
• If the doctor suspects a broken bone or damage to the eyeball, they may take an X-ray or CT scan.
• If there is concern about the eye itself, they may refer you to an eye specialist for a closer look with a microscope and eye pressure checks.

What to expect at your appointment

The examination is quick and does not hurt. You may be asked to read letters on a chart and follow a light with your eyes. In most cases, the doctor will reassure you that the black eye will heal on its own and give you advice on how to look after it.

Treatment

Treatment helps reduce pain and swelling while the body reabsorbs the bruise. In most cases, no medical treatment is needed.

Self-care at home

• Apply a cold compress (such as a clean cloth dipped in ice water) gently to the eye for 15 to 20 minutes every 2 to 3 hours for the first 24 to 48 hours. Do not press directly on the eyeball.
• After the first 2 days, switch to a warm compress to help the bruise fade.
• Keep your head raised, including when sleeping, to reduce swelling.
• Take simple pain relief if needed. Ask your pharmacist for advice.
• Avoid any activity that could bump the eye again until it has healed.

Medical treatments

Medical treatment is rarely needed for a black eye. A doctor may suggest over-the-counter pain relief and eye rest. If there is damage to the eye itself, the doctor may refer you to an eye specialist for further care. In some cases, they may prescribe drops or ointments to protect the eye, but this is not a routine part of black eye treatment.

When is surgery considered?

Surgery is only needed if there is a deep cut that needs stitches, a broken bone around the eye socket, or an injury to the eyeball itself that requires repair. This is uncommon.

Living with this condition

A black eye will change colour over a week or two as it heals. The swelling usually goes down within a few days, and the bruise fades over about 1 to 2 weeks. You can carry on with normal daily activities, but you should protect your eye and avoid contact sports until it feels better.

Lifestyle tips

• Wear protective eye goggles or a face guard for sports and DIY tasks.
• Always wear a seatbelt when in a vehicle.
• Wear a helmet for cycling, riding a motorbike, or climbing.
• Make sure your home is well-lit and free of trip hazards to avoid falls.

Diet and exercise

Eating a balanced diet with plenty of fruits and vegetables may help your skin heal. Gentle exercise is fine, but avoid anything that could cause a blow to the face until the bruise has fully resolved.

Mental health and emotional wellbeing

A black eye is very visible and can sometimes bring unwanted attention or embarrassment. This is understandable. Remember it is temporary, and there is no need to be ashamed. If you are feeling distressed about how you look, speaking to a friend, family member, or counsellor can help.

Prevention

Many black eyes can be prevented by taking simple safety steps. Wearing protective eyewear during sports and DIY, using seatbelts, and keeping your home free of obstacles can all reduce the risk of facial injuries.

Complications

If left untreated

• Injury to the eyeball, for example bleeding inside the front part of the eye, which needs emergency care
• Damage to the bones around the eye (an eye socket fracture)
• Double vision if the muscles around the eye are trapped or injured
• Infection under the skin or inside the eye, especially if there is a wound
• Increased pressure inside the eye that could affect vision

Long-term outlook

The outlook for a black eye is excellent. Most black eyes heal fully within 2 weeks without leaving any lasting mark. With simple home care and a little patience, you can expect a complete recovery. If there is an underlying injury, early medical attention ensures the best possible outcome.

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