A black eye refers to bleeding in the area of ​​the eyelid or the eye socket. It can occur as a result of a fall, an accident, as a result of operations or in connection with certain illnesses.

What is a black eye?

According to acronymmonster, the so-called hematoma or bruise occurs when blood vessels are torn open or destroyed in and under the individual skin layers, the muscles or the blood supply to the facial and cranial bones and describes the visible bleeding into the surrounding tissue directly in and under the skin.

This takes up space and thus brings various symptoms, depending on the extent, such as the typical discoloration of the area, edema formation and pain. The localization on the lower or upper eyelid or in and around the eye sockets is also important here.

Causes

The causes include mundane falls or accidents that result in injuries to the eyes. Blows to the eye, temple, forehead or jaw can also be associated with such bleeding, as the area of ​​the eye is supplied with many fine capillary vessels.

Especially patients who regularly have to take antidepressants or blood-thinning agents such as Marcumar or Xarelto® are particularly at risk in these situations. The blood often fills the area of ​​the bags under your eyes very quickly and forms enormous edema and effusions below the eye. Various diseases can also bring about bruises. A monocle or eyeglass hematoma describes a ring-shaped appearance of the bruise around one or both eyes.

The term eyeglass hematoma describes a symptom that affects both eyes. If there is no injury to the eyes or the directly surrounding structures, it is often an indication of a skull base fracture or a tumor formation in the brain. In any case, a doctor should be consulted here, who will undertake further diagnostics.

Operations such as laser surgery for cataracts, an increasing clouding of the lens of the eye, which is replaced by an artificial lens in the course of the operation, can often result in a hematoma located on the lower eyelid.

Symptoms, ailments & signs

A black eye is usually caused by external force, so that it comes to the usual discoloration. Such a discoloration is probably the most common sign of a black eye. Often, ruptured blood vessels indicate a black eye, which can be clearly seen on the white eyeball. Increased tear flow is also a symptom that is very often associated with a black eye.

Of course, there are more than just external phenomena in a black eye. Even a slight feeling of pressure in the area of ​​the blue eye can lead to severe pain. Swelling around the eye is also possible and is a clear indication of an impending black eye.

The swelling can increase over time and the pain often gets worse. However, permanent cooling of the affected area can effectively counteract this complaint. Complaints such as severe swelling, a constant feeling of pressure and headaches are also not uncommon. Nevertheless, a black eye is not a disease that must be treated by a doctor. If there is no fracture, medical treatment is not necessary.

Diagnosis & course

After a blow to the face without an open wound, there is usually reddening, which indicates the contusion and damage to the tissue and the capillaries located there. Edema later develops and lymph fluid enters the tissue. The hemorrhage usually only becomes visible after a few hours.

A vascular injury is inevitable here. A side-by-side comparison is carried out diagnostically by means of inspection and palpation. This provides information about the extent of the tissue change. In the case of complicated injuries and fractures, the bony structure can be clarified by the doctor using X-rays and CT and the soft tissue situation using ultrasound and MRI. The course of the disease now primarily consists in the healing of the injured vessels and the removal of coagulated blood particles and stored lymphatic fluid back into the body’s circulation.

It takes about 14 days to achieve normal skin color. The color of the effusion shows both the extent of the injury and the healing progress from red to blue and green / yellow. Blood coagulation begins at the blue color stage. The following color changes arise from the composition of the blood components still present in the affected area and the breakdown of hemoglobin.

Complications

A black eye is harmless in most cases; however, it can sometimes lead to complications. First of all, the bruise can trigger various accompanying symptoms such as headache or dizziness. If the bruise does not heal on its own, there is a risk of inflammation or encapsulation of the injured tissue. Rarely, such inflammation can lead to life-threatening bleeding in the brain area.

Patients with hemophilia or who regularly take blood-thinning medication are at increased risk. If there is a concussion in addition to the black eye, impaired consciousness, feelings of weakness and nausea can occur, among other things. If there is bloody discharge from the ears, mouth or nose, there may be a fracture of the base of the skull which, if left untreated, is life-threatening.

When treating blue eyes, complications are rare; Treatment with cooling compresses can lead to hypothermia in the affected area, and known home remedies such as chilli or petroleum jelly can further irritate the sensitive area around the eyes if used incorrectly. In order to rule out any complications, a black eye should always be clarified by a doctor.

When should you go to the doctor?

A black eye is usually caused by external force, which can lead to discoloration around the eye. At the same time, this clinical picture is also associated with pain, especially when considerable pressure is exerted on the affected region. However, a black eye should heal or the swelling and coloration should subside within three to four days. The existing pain should also slowly subside. If there is no clear improvement after the period mentioned, then you should definitely consult a doctor.

In many cases, pus develops in addition to the blue eye. In such a case, if left untreated, an abscess can occur. Treatment by a doctor is of course also required for an abscess. This is the only way to ensure rapid healing and recovery. Therefore, if there is no clear improvement in a black eye after three to four days, see a doctor as soon as possible. Serious damage can only be identified at an early stage and treated appropriately through a professional examination.

Treatment & Therapy

In the acute phase, cooling should be applied as quickly as possible. This immediately constricts and closes blood and lymph vessels, reduces or prevents further fluid leakage and thus reduces the extent of swelling.

However, an ice pack should not be used or this cloth should be wrapped in order to avoid the risk of frostbite. These develop very quickly and show the same symptoms as a burn. A cold, wet cloth is sufficient for effective cooling. Furthermore, depending on the size, hemostasis can be achieved by pressing the area with your hand or thumb. To promote the further healing process, there are various ointments that can be prescribed by the doctor.

Extracts from arnica, marigold or St. John’s wort or corresponding Schüssler salts also support the breakdown process. Therapies such as lymphatic drainage can be prescribed by the doctor to reduce swelling. A gentle stroke from the inside out towards the temple also promotes lymph drainage and can be done several times a day by the patient himself.

In general, the healing process depends on the physical constitution and age of the patient, the state of health, any other illnesses or injuries and the use of medication.

↳ Additional information: Home remedies for bruising

Outlook & forecast

The prognosis in the case of a hematoma on the eye is generally to be regarded as favorable, provided that there are no complications associated with it. In most cases, the mere swelling will recede on its own, whereby the person affected can accelerate the healing process with various hand movements.

No consequential damage is to be expected in a black eye. People who take blood thinners or suffer from the hemophilia have a less favorable prognosis. With them, the hematoma will take significantly longer to heal, although they too can influence the healing process through cooling and other methods.

If there were complications related to the black eye, the prognosis is based on these. Bleeding into the eye or broken bones are much more serious than a slight infection in the area. The prognosis is less favorable, the more tissue around the eye and the hematoma is additionally damaged. Further bleeding, poor vision and severe pain speak for deeper injuries that require further clarification.

Overall, a violet heals well within seven to ten days with adequate cooling. Traces of the hematoma can persist for a long time – also depending on the thickness of the skin, age, etc.

Prevention

Physical fitness is an important aspect to prevent black eyes or other hematomas or to keep the extent low after a fall or accident. Good circulation, a regular heart rhythm, and healthy blood pressure are factors that help prevent excessive bleeding. Regular preventive medical checkups are recommended for this.

Aftercare

A black eye can appear in different degrees of severity, so that in some cases several follow-up examinations are necessary. A black eye is a bruise that occurs directly on the eye. Normally, no medical or drug treatment is necessary at all.

A black eye disappears automatically after a few days, so that nothing should stand in the way of a complete and timely recovery. Since a black eye usually occurs as a result of strong external violence, a doctor should be consulted in particularly severe cases. If the swelling or the bluish discoloration does not subside after five to six days, the person concerned should opt for an appropriate follow-up examination.

There may be a fracture in the face due to the violence. Such a fracture can only be determined through an appropriate examination. So the following applies: A black eye is usually not a clinical picture that requires a medical examination or a follow-up examination.

However, if the eye swelling is particularly severe, the affected person should opt for a follow-up examination. Only with such a subsequent examination can further complications be identified and avoided at an early stage. This will ensure a full recovery.

You can do that yourself

A black eye does not necessarily need medical treatment. It is usually sufficient to cool the hematoma immediately with ice, [[cold-warm compress | ice packs], a quark envelope or a bag of frozen vegetables. It should be noted that the ice should not come into direct contact with the skin in order to avoid frostbite. In the following days, the black eye can be treated with warm compresses.

In addition, various home remedies such as arnica or chamomile can be applied, for example in the form of an ointment or a tincture. Natural anti-inflammatory drugs such as lemon balm or ginger can also be reapplied to the hematoma over and over again. During the healing phase, the black eye should be protected from further damage by applying a suitable bandage. Sports glasses and other protective equipment should be worn when exercising. While sleeping, the eye can be protected by sleeping on the other side.

As a visual measure, it is recommended to cover the blue eye with make-up or camouflage. After one to two weeks at the latest, the hematoma should finally have subsided. If pain or discoloration persists, a doctor is recommended.

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