Black Eye

A black eye is bruising around your eye that develops after trauma to your face or head. The bruises form on your upper and lower eyelids and the skin around your eye. These bruises may look purple, blue and/or black in color. Despite its name, a “black eye” doesn’t mean your eye itself is injured. It just refers to the skin around your eye.

But there’s a catch — sometimes, the trauma that causes a black eye can do further damage. For example, you might have broken bones around your eye or elsewhere in your head. Or there might be damage to your eye itself.

Your eyes are too important to leave to chance. Even if you think you’re fine, don’t just reach for an ice pack and call it a day. See a healthcare provider as soon as possible after getting a black eye (ideally within one to two hours before swelling sets in). They’ll check your eyes and surrounding areas for any further damage. And they’ll make sure you get the care you need.

Symptoms of a black eye

Symptoms of a black eye include:

• Discolored skin (bruising) around your eye
• Pain around your eye area
• Swelling around your eye that may get worse after an hour or two and make it hard for you to open your eye

Black eye stages

A black eye can look different as time goes on. Initially, the skin around your eye might look red. Then, it might change to a deeper red. The redness may then shift to purple, yellow, green or black.

If you have a darker skin tone, the bruising may look purple, dark brown or black.

Black eye causes

The most common cause of a black eye is sudden trauma to your eye area. For example, it’s possible to get a black eye if:

• A ball hits you in the eye
• You walk into a door or other structure
• You fall and your face lands on something hard
• Someone hits or punches you
• You’re in a car accident

This trauma damages tiny blood vessels just beneath your skin. When these vessels get hurt, they start to leak blood. The blood builds up under your skin, causing bruising and swelling.

What if I have a sudden black eye without an injury?

Not all black eyes happen due to an injury. It’s also possible to develop a black eye after:

• Dental surgery, like having your wisdom teeth taken out or getting dental implants
• Facelifts or nose surgery
• Jaw surgery

You might wonder how surgery in your mouth or somewhere else in your face can cause bruising around your eye. It’s because surgery can cause a bit of blood to leak out. This blood can then move beneath your skin. When it reaches the delicate area around your eyes, it forms a bruise.

Black eyes can also develop as a side effect of a new medication or treatment. If this happens, tell your provider right away. They may want to adjust your treatment plan.

You can also develop bruising or discolored skin due to other medical conditions. Below are some examples.

Spontaneous periocular ecchymosis (SPE)

Although rare, some people develop black eyes out of nowhere — without a history of trauma or facial surgery. Healthcare providers refer to this as spontaneous periocular ecchymosis. Often, both eyes are affected (“raccoon eyes”). The causes are often quite serious and include:

• Amyloidosis
• Certain types of cancer
• Increased intracranial pressure along with vascular malformations in your eye area
• Migraine

Allergic shiners

It’s possible to develop dark circles that look like black eyes but aren’t actually bruises. Allergic shiners are discolored circles under your eyes that form due to nasal congestion. Swelling in the inner lining of your nose slows down blood flow in veins near your eyes. When these veins swell, the skin that covers them turns dark and puffy.

Complications of this condition

A black eye itself doesn’t lead to complications. This is temporary bruising that will heal on its own. But the trauma to your face or head that caused the black eye may lead to other complications, including:

• Bleeding in your eye (hyphema)
• Broken bones around your eye (orbital fracture) or elsewhere in your face or head
• Dislocated lens
• Raised pressure inside your eye (ocular hypertension)
• Retinal tears or detachment
• Vitreous hemorrhage

How doctors diagnose a black eye

Healthcare providers diagnose a black eye by examining your eye area. They look for the bruising and swelling typical of a black eye. They may also:

• Ask you to read letters on a screen to check your vision
• Move their finger from side to side, in front of your face, to see how well your eyes can follow along
• Dilate your pupil to closely examine the inside of your eye
• Gently touch different areas of your face to check for broken bones
• Run tests, like an X-ray or CT scan, to look for broken bones or other issues

How to treat a black eye

If an injury caused your black eye, you can treat it by using cold compresses. These help stop bleeding under your skin and reduce swelling. Here’s what to do:

• Gently place a frozen gel pack or a bag of crushed ice over your (closed) eye. Leave it on for about 15 to 20 minutes.
• Repeat as often as once per hour.
• If you don’t have a gel pack or ice, you can use a bag of frozen veggies — ideally corn or peas, which you can bend into the right shape.
• No matter what you use, cover it with a thin towel to avoid harming your skin.

One method not to try is putting a slab of raw meat on your eye. Raw meat is covered in bacteria that could cause an infection. Plus, there’s no proof it actually does anything to reduce swelling.

If you have a black eye after surgery or for other reasons, ask your provider how best to treat it. They’ll give you advice specific to your situation.

When should I see a healthcare provider?

You should always see a healthcare provider if you have a black eye due to trauma to your eye area. Your provider will check for further damage beyond bruising and make sure you get the necessary treatment. They may just tell you to go home and apply ice — but it’s better to know for sure that bruising is the only concern.

It’s especially important to see a provider right away if you have additional symptoms like:

• Bleeding from your eye, nose or ears
• Changes to the size or shape of your pupil
• Changes to your vision, like double vision or vision loss
• Dizziness or fainting
• Headache that’s severe or won’t go away
• Numbness anywhere in your face
• Pain when moving your eye
• Trouble moving your eye
• Severe pain around your eye
• Vomiting

It’s also crucial to see a provider right away if you develop black eyes and can’t identify the cause.

If you develop a black eye after a dental or facial surgery, call the provider who did the surgery. They can explain if this is an expected side effect and what you can do to help with healing.

How long does a black eye last?

A black eye usually heals within several weeks. But the total healing time can be longer if you have other injuries besides the bruises around your eye. Your healthcare provider can tell you more about what you can expect.

While your eye heals, avoid activities that could cause further injury to your face or head.

Can I heal a black eye overnight?

Unfortunately, there’s no fast fix for a black eye, and you can’t heal it overnight. But applying ice every hour or so within the first 24 hours can help stop the bleeding under your skin and reduce swelling.

Using under-eye concealer or foundation can help make the bruising less noticeable while you heal.

Is it possible to have a delayed black eye after a head injury?

Yes. It’s possible to develop black eyes one to two days after a skull fracture. You might not even realize the trauma to your head caused a fracture. So, the black eyes are the first sign of something more serious. See a healthcare provider immediately.