Understanding Vision

Black eye

What causes it and how to treat it

25. August 2021

Eye problems such as blurry vision can drastically influence your quality of life. It’s difficult to perform daily tasks such as driving, reading or working at your computer when your vision is hazy and out of focus. On top of the fact that blurred vision can affect your daily life, it can also be a sign of other more serious health conditions or eye problems. BETTER VISION explains what the possible causes are, and what can be done to improve eyesight.

What is a black eye, how long does it last, and what causes it?

A black eye or periorbital hematoma is a bruise around the eye that is generally contained within the eye sockets.

Blunt force trauma around or close to the eye can cause capillaries to burst and lead to bleeding under the skin¹. Because of the fatty tissues and lack of muscle surrounding the eyes, the blood tends to gather here, and the skin appears dark red, purple or black, and bruised. The appearance of bruises and soft tissue swelling is worsened by close proximity to the bone , and the fact that the skin around the eyes is quite thin.

What is a black eye, how long does it last, and what causes it?

Blunt force trauma (this is different from a penetrating injury) is usually caused by any type of blow to the eye. Other causes of black eyes include:

Sinus infections, or an allergy or allergic reaction (from a bee sting to the nose or eyelid, for example).
Facial surgery such as nasal surgery.
Aesthetic treatments such as anti-wrinkle injections.
Dental problems such as abscesses or tooth infections.
Basal skull fractures can result in two black eyes called “raccoon eyes” or “panda eyes”, where blood from the fracture pools around the soft eye tissue. Seek medical attention if you suspect a skull or head injury .

Due to blunt force, blood vessels in the eye can burst and the white part of the eye (the sclera) will appear red and bloodshot.

How long does a black eye last?

Depending on how severe the injury is and your age, a black eye can disappear in about two weeks . Within a day or two following the injury, the swelling and discolouration will most probably be at its worst, as the haemoglobin in the blood gathered around the eye breaks down. Following this, the swelling will gradually go down, and the bruise will fade from dark red or black to a yellow-green hue, before fading away completely.

It’s important to get a medical opinion if the discolouration and swelling takes particularly long to disappear, or it doesn’t show any signs of fading after two weeks.

Black eyes are often accompanied by broken blood vessels in the white part of the eye (subconjunctival haemorrhage). The eye will appear red and bloodshot, but although it may look painful and serious, you may not experience anything other than a little scratchiness on the eye surface.

Along with your bruise, the red patch will fade away over time and there’s no need to see a doctor if it’s not accompanied by a discharge, or if it doesn’t reappear concurrently.

Applying a cold compress to the eye area shortly after an injury can reduce swelling and soothe pain.

First aid measures for treating a black eye

Following a blow or punch to the eye, it’s best to soothe the area by applying a cold compress. Do this as soon as possible after the injury, preferably within 48 hours.

If you have an ice pack or gel ice compress, wrap it in a cloth and gently hold it against the affected area. Instant cold compresses like those found in first aid kits can be activated by squeezing the pack.

You can also place a handful of ice cubes or a bag of frozen vegetables in a cloth if you don’t have an ice pack handy. Whatever you use, make sure it’s wrapped in a clean layer of fabric so it doesn’t come in direct contact with the bare skin, as this can cause ice burns and scars. Raw meat can carry bacteria, so it’s best to leave your steak for the grill.

Hold the compress against the affected area for no longer than 20 minutes at a time. You can do this for a few days to alleviate pain and limit swelling.

A black eye is often accompanied by a minor headache or sensitivity and eye pain. You can take painkillers such as paracetamol or ibuprofen, but avoid aspirin as it thins the blood and make bruising appear worse.

When to seek medical help

Despite the term “black eye”, the eye itself isn’t always injured or necessarily affected by the trauma. If you suspect that it is, consult a healthcare practitioner as soon as possible.

Chances are good that your shiner isn’t cause for concern, but there are circumstances that warrant a visit to your nearest doctor or emergency room. According to the American Academy of Ophthalmology, these are signs of possible serious eye injury²:

Ongoing pain experienced in the globe of the eye.
If you have blurry vision or struggle to see with the injured eye, compared to the unaffected eye.
A torn or cut eyelid that may require stitches.
Eyes that can’t move together or in unison as usual.
An unusual pupil size or shape compared to the other eye.
When one or both eyes appear to be protruding from the sockets.
Blood or accumulation of fluid in the clear part of the eye in front of the pupil (hyphema). This is a serious condition, and if left untreated, can lead to increased eye pressure and possible vision loss due to glaucoma.
A particle or object inside the eye that causes tearing and irritation and that can’t be removed.

How to get rid of a black eye

There’s no special black eye treatment that exists. The only option is to wait it out and let your body and the tissue heal itself.

Initially, it’s best to place ice on the affected area. If it’s still painful after two days, try a warm compress but be careful not to make it too hot – it shouldn’t burn your skin. The heat may support the metabolic breakdown and speed up the healing process.

Get enough rest, drink plenty of fluids, and take care not to injure the area any further.

How to cover up a black eye

Black eyes tend to draw a lot of attention and it can be embarrassing to appear in public with your bruise! The easiest way to disguise your shiner is with a large pair of sunglasses.

It’s best to leave the concealer and black eye makeup until the swelling subsides. Make sure that there aren’t any open cuts on the skin before applying concealer.

Eye injuries can be prevented if you wear protective glasses or specially designed sports goggles.

How to prevent eye injuries

Black eyes and eye injury can be prevented in some cases. Your everyday glasses should definitely be made from a shatterproof material, and if you are uncertain about the quality, consult your eyecare practitioner.

You should wear protective eyewear in the following instances:

If you work in a profession where the risk of eye injury is big, such as construction.
When you work on DIY projects at home that involve power tools or fast moving objects.
If you participate in sports such as squash, it’s always advisable to wear protective sports eyewear.
When you participate in any activity where there’s a risk of eye injury, opt to wear protective goggles or a helmet with a shield.

The appearance of bags under the eyes can be exacerbated by a lack of sleep, diet, stress and lifestyle choices.

What causes dark circles under the eyes?

Unlike black eyes that are caused by some form of injury, bags under the eyes or puffy eyes is mostly a cosmetic concern. As already mentioned, the skin around and under the eyes is quite thin, and discolouration will appear more prominent in this area.

There are a number of reasons why you may have dark circles under your eyes. Skin tone and texture, and genetics certainly play a role.

The intensity of swelling and hue can also increase for the following reasons:

Lack of sleep.
When you have a sinus infection or are prone to allergies.
Due to ageing skin.
Increased levels of stress.
When your fluid intake is too low.
When you consume a lot of salty or processed foods, fluid retention is higher and this may result in excess swelling around the eyes.
Smoking.
Excessive use of alcohol.

Read more about eye allergies and fast remedies

Make healthy lifestyle choices – it may help a black eye to fade away faster.

How to get rid of dark circles under your eyes

Cosmetic treatments can offer a permanent, or semi-permanent solution to bags under the eyes. These include fillers, blepharoplasty (cosmetic eyelid surgery which may include the excision and removal or reposition or both of excess skin, fat and the reinforcement of corresponding muscle and tendon tissues), laser treatments, or chemical peels. Consult a trustworthy aesthetic practitioner for more information.

Alternatively, you can try any of the following home remedies and lifestyle improvements:

Apply lightening cream or eye cream daily, especially moisturising products that contain vitamin E.
Reduce sun exposure, and make sure your eyes and the area surrounding them are protected from harmful UV rays by wearing sunscreen or glasses that offer protection up to 400 nm.
Drink plenty of fluids and follow a healthy diet that includes lots of fresh fruits and veggies.
Get at least 7 hours of sleep every night.
Elevation – sleep in a more upright position by adding an extra pillow to your bed at night.
Massage the eyes to improve circulation.
Place tea bags or cucumber slices on the eyes for at least 10 minutes, once or twice weekly.
Treat yourself with a cooling eye gel mask from time to time to reduce swelling.

Learn more about ZEISS Lenses with UVProtect Technology

When to see a doctor about dark circles under the eyes

Dark circles can be associated with thyroid issues, anemia, allergies or vitamin deficiencies . If the discolouration appears suddenly and gets drastically worse over a short period of time, consult your medical practitioner.