What Is It?
A black eye, sometimes called a "shiner," is a bruise around the eye. When an object strikes the eye, the force of the impact breaks delicate blood vessels in the eyelids and surrounding tissues. Blood collects under the skin, and causes black or blue discoloration in the eyelids and around the eye socket. Because the skin around the eye is relatively thin and transparent compared to skin in other parts of the body, the black and blue color of a bruised eye may seem darker and more intense than bruises elsewhere.
Although many people associate black eyes with fighting and violence, only about 15% of eye injuries are caused by violent assaults. Most black eyes happen by accident -- during contact sports, at work, in a car crash or during home repair. Men get about four times more eye injuries than women do, and the average patient is approximately 30 years old. The source of the injury is usually a blunt object -- a baseball, a hammer, a rock or a piece of lumber -- and the most frequent place of injury is the home. At one time, it was also common for eye injuries to occur in motor vehicle accidents, usually when a victim's face struck the dashboard. However, the number of eye injuries caused by car crashes has decreased significantly because of airbags and the mandatory use of seat belts.
Almost 2.5 million traumatic eye injuries occur each year in the United States. Most black eyes are superficial injuries that don't cause any permanent damage to the eye or to the tissues around it. When vision changes after a blow to the eye, it is a warning sign that the injury may be more than a simple bruise. The force of the blow may have fractured the delicate bones that form the eye socket, or the structure of the eye itself may be damaged.
A black eye causes swelling and black-and-blue discoloration of the eyelids and soft tissues around the eye.
Sometimes, trauma that results in a black eye also causes small areas of bleeding on the white of the eye and on the inner lining of the eyelids. If you have bright-red or dark-red discoloration of your eyeball, you have another problem. This discoloration most likely is caused by a condition called a subconjunctival hemorrhage, which means a small blood vessel in the eye breaks and bleeds. This bleeding can be caused by trauma or by retching or vomiting. Like a black eye, the color change from a subconjunctival hemorrhage typically goes away slowly on its own, and the condition does not need any treatment.
You usually can diagnose a black eye yourself.
Most of the swelling and discoloration go away within 7 to 10 days after injury. The color of the skin around the eye will change over the course of recovery, typically showing green and yellow tones as the blood ages and is cleared from the tissue.
Almost all eye injuries can be prevented. To decrease your risk of eye injuries:
If you have a black eye, apply cold compresses (such as an ice bag or cool, damp cloth) to the injured eye for at least 15 minutes immediately after your injury to help reduce pain, swelling and discoloration.
When to Call a Professional
Most black eyes are no more dangerous than a simple bruise on your arm or leg. There are times, however, when a black eye can be a sign of a more serious problem, such as a fracture of the eye socket or an injury to the inside of the eye. Call your doctor immediately if your black eye is accompanied by any of the following symptoms:
An uncomplicated black eye heals without complications.
National Eye Institute
2020 Vision Place
Bethesda, MD 20892-3655
National Institute of Environmental Health Sciences (NIEHS)
P.O. Box 12233
Research Triangle Park, NC 27709
American Academy of Ophthalmology
P.O. Box 7424
San Francisco, CA 94120-7424
American Society of Ophthalmic Plastic and Reconstructive Surgery
222 S. Westmonte Drive
Altamonte Springs, FL 32714
U.S. Department of Labor's Occupational Safety & Health Administration (OSHA)
200 Constitution Ave.
Washington, D.C. 20210
Prevent Blindness America
500 East Remington Road
Schaumburg, IL 60173
National Institute for Occupational Safety and Health
4676 Columbia Parkway
Mail Stop C-18
Cincinnati, OH 45226
American Academy of Pediatrics (AAP)
141 Northwest Point Blvd.
Elk Grove Village, IL 60007-1098