Understanding and Treating Black Eyes

A Patient's Guide to Periorbital Hematoma

Urgent Care

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Last updated: Mar 24, 2025

What Is a Black Eye?

A black eye, medically known as a periorbital hematoma, occurs when blood and other fluids collect in the space around the eye following an injury to the face or head.

Common Causes

  • Direct trauma to the eye area
  • Facial injuries or accidents
  • Sports injuries
  • Falls
  • Nasal surgery complications
  • Dental procedures

Symptoms

Primary Symptoms

  • Bruising around the eye
  • Swelling of the eyelid and surrounding tissues
  • Pain and tenderness
  • Possible difficulty opening the eye

Warning Signs

  • Vision changes or blurriness
  • Severe pain
  • Blood in the white of the eye
  • Inability to move the eye

Treatment

Immediate Care (First 24-48 Hours)

  1. Apply cold compresses for 15-20 minutes at a time
  2. Keep head elevated, including while sleeping
  3. Take over-the-counter pain relievers if needed

Ongoing Care

  • After 48 hours, switch to warm compresses
  • Gentle massage of the area to promote circulation
  • Protection from further injury

When to Seek Medical Attention

Seek immediate medical care if you experience:

  • Double vision
  • Loss of vision
  • Severe pain
  • Blood pooling in the eye
  • Clear fluid leaking from the nose

Recovery Timeline

Most black eyes heal within 2-3 weeks, following this pattern:

  1. Days 1-3: Peak swelling and darkness
  2. Days 4-7: Color changes begin
  3. Days 8-21: Gradual fading

Prevention

  • Wear protective eyewear during sports
  • Use appropriate safety equipment
  • Practice caution during high-risk activities

Complications

Rare but serious complications may include:

  • Orbital fracture
  • Vision damage
  • Traumatic hyphema
  • Retinal detachment

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