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Black Eye: Causes, Treatment & Complications

Medically reviewed by Victor Paulino, MD, DPBO · Ophthalmology · Makati Medical Center

Written by Jen Mallari · Updated Aug 25, 2022

    Black Eye: Causes, Treatment & Complications

    A black eye refers to an injury around the eyes or surrounding facial areas. It appears to be dark in color, usually a mix of a bluish-purple hue.

    This is due to the blood and other fluids that mix and get into the areas around the eyes. Apart from looking bruised, this type of injury may also appear swollen. 

    Black Eye Injury: What are its possible causes?

    This type of eye injury can be caused by trauma to the face and hits one of the most sensitive areas in the face which is the area around the eyes.

    Although the term black eye was coined for this type of injury, it does not actually injure the eyes, rather, the areas around it. In most cases, a black eye would heal all on its own after a few days. However, there are circumstances wherein a black eye injury is considered severe. 

    This type of injury will be considered severe once there is bleeding inside the eye (this is called hyphema).

    black eye

    This should be treated with urgency since a severe injury such as hyphema can cause damage to the cornea, ultimately affecting one’s vision.

    Another sign of an intense injury would be having two black eyes and double vision after suffering an injury to the head. This type of injury usually indicates a skull fracture.

    There are a few ways where one can indicate whether or not this is a much more serious injury:

    Symptoms to watch out for:

    • Vision becomes blurred 
    • There is pain around the eye 
    • Mild swelling around the eye that increases in size over time. 
    • There is bruising around the eye with a reddish hue at first then becomes darker over time. Red turns to purple, yellow, green, or black. 

    Symptoms of a more serious injury:

    • There is vision loss 
    • There is double vision 
    • There is blood, or other fluids, coming out of the eyes or nose
    • Having difficulty in moving the eyes 
    • Passing out/losing consciousness 
    • Experiencing headaches 
    • Having blood on the eye’s surface 

    What Causes a Black Eye?

    Blunt force to the face usually causes this condition, so whether a person gets hit directly in the face and hits the eyes or the nose, they will get a black eye.

    Depending on where a person was hit in the face, a black eye can either affect only one eye or both. If a person gets hit on the nose, both eyes will be bruised and swollen. 

    The injuries aforementioned are not severe injuries, however, other causes like skull fractures are the ones considered as severe. These not only cause two black eyes but also bleeding on the surface of the eyes as well as having double vision and such. 

    Lastly, another common cause of black eye would be surgeries done to the face such as nose surgery, facelifts, and jaw surgery. 

    What Happens After You Get a Black Eye?

    This type of injury usually goes away on its own after at least 14 days. People can do a quick and easy home remedy to speed up the healing process, such as placing a cold compress on their black eyes right away.

    It is recommended to keep the cold compress on for 15 to 20 minutes per hour (this should be done while you are awake). Do this for 24 hours to reduce the swelling.

    After 24 hours of routinely applying a cold compress, you may switch to a warm compress. This allows continuous blood flow to the areas around the eye. Make sure that you do this step gently as you do not want to put too much pressure on the eye. 

    Avoid engaging in physical activities for a while to minimize exposure to possible injuries to their head. 

    How to Treat a Black Eye?

    • Avoid doing any activities that make you exert effort as this would worsen the swelling of the black eye. Just rest for the first two days after having a black eye. 
    • Apply a cold compression to your black eye to reduce the swelling. 
    • Apply warm compression after 24 hours of applying cold compress. 
    • Keep the head elevated to reduce swelling. 

    Complications of Eye Bruises or Injuries

    There are several complications that come with having a severe black eye injury such as:

    • Uveitis (internal damage to the eye that causes blurred vision, irregularly shaped pupil, and the like) 
    • Glaucoma (this is increased pressure inside the eye that may cause permanent damage to the optic nerve)
    • Orbital floor fracture (this causes double vision or possibly loss of vision)
    • Retinal detachment (permanent vision loss)
    • Hyphema (visible bleeding in the eye) 

    Key Takeaway

    Once you get a black eye it is imperative that you have it checked immediately so that doctors can diagnose whether it is a severe head injury or not. Ensure that you are also treating your black eye the right way and avoid strenuous activities as much as possible. 

    Important: If your eye injury has been inflicted by another person, please contact your local authorities and seek emergency help immediately.

    Learn more about eye health here.


    Hello Health Group does not provide medical advice, diagnosis or treatment.

    Medically reviewed by

    Victor Paulino, MD, DPBO

    Ophthalmology · Makati Medical Center

    Written by Jen Mallari · Updated Aug 25, 2022

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