Black Eye

  • Medical Author:
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

  • Medical Editor: David Perlstein, MD, MBA, FAAP
    David Perlstein, MD, MBA, FAAP

    David Perlstein, MD, MBA, FAAP

    Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.

What are the signs and symptoms of a black eye?

Edema (swelling) and pain are the most common signs and symptoms of a black eye, and may be accompanied by discoloration caused by bruising.

Initially, the swelling and discoloration may be mild. The area around the eye often starts off slightly reddened, and then progresses to a darker shade and swelling increases. Some blurry vision or difficulty opening the eye may occur, but more serious visual problems are less common. Over the course of a few days, the area becomes lighter and the swelling decreases.

Signs of a more serious injury are double vision, loss of sight, or inability to move the eye. Loss of consciousness, blood or clear fluid coming out of the nose or the ears, blood on the surface of the eye itself, or persistent headache can also indicate a severe injury.

When should I call the doctor for a black eye?

Most black eyes are minor injuries that heal on their own in a few days with ice and OTC pain medications. Depending on the mechanism of injury and accompanying symptoms, an ophthalmologist might have to examine the injured eye to make sure that no significant injury to the eye has occurred.

Call a doctor if the patient:

  • experiences changes in vision;
  • has severe pain or swelling that does not go away;
  • has swelling around the eyes that is not related to an injury;
  • has signs of infection (for example, fever, warmth, redness, pus-like drainage),
  • has behavioral changes, 
  • has forgetfulness or lethargy, or
  • nausea, vomiting and/or dizziness.

Patient's should consult a health care practitioner any time they are unsure about treatment or concerned about symptoms.

Some conditions require immediate medical care. Call 9-1-1 or get to an emergency department immediately in the following situations:

  • the patient experiences changes in or loss of vision (especially double vision);
  • an inability to move the eye itself (i.e., unable to look in different directions);
  • any injury in which an object may have pierced the eye or may be inside the eyeball;
  • if there is obvious blood in the eye itself;
  • if there is deformity to the eye;
  • fluid leaking from the eyeball;
  • there are any lacerations (cuts) to the eye area, face, or head;
  • the patient has signs of a serious head or facial injury;
  • if the black eye is accompanied by broken bones or teeth;
  • loss of consciousness;
  • changes in behavior;
  • nausea, vomiting and/or dizziness;
  • inability to walk;
  • blood or clear fluids coming out of the nose or the ears;
  • ppatients who take blood thinners, such as warfarin (Coumadin), or those with a history of bleeding problems such as hemophilia;
  • swelling after a bee sting near the eye; or
  • from a suspected infection of the eye.

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