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Eye Contusion

(Black Eye; Blunt Eye Injury; Ecchymosis)

 

Definition

An eye contusion is a bruise around the eye, more commonly known as a black eye. It may occur when a blow occurs in or near the eye socket. If a bruise appears, it will usually do so within 24 hours of the injury.

Eyelid Contusion

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Causes    TOP

After being struck in the eye or nose, blood leaks into the area surrounding the eye.

 

Risk Factors    TOP

Factors that may increase your risk of an eye contusion include:

  • Participation in high-impact sports such as basketball, football, hockey, and boxing
  • Occupations that expose the eye to potential injury, such as manufacturing, construction, and athletics
  • Fighting or other trauma
 

Symptoms    TOP

A black and blue or purple mark will appear following the injury. There may also be redness, swelling, and tenderness or pain. After it begins to heal, the contusion may turn yellow.

 

Diagnosis    TOP

Eye contusions are diagnosed visually. Healthcare providers assume that the eye has been struck in some way. Most people are able to self-diagnose a contusion, but a doctor may confirm the diagnosis.

 

Treatment    TOP

First-aid Treatment

It is important to apply first-aid treatment right away.

  • Seek emergency medical attention right away.
  • Immediately apply an ice pack for 15-20 minutes at a time to reduce swelling and minimize pain. Do not press on the eye itself. Repeat every 1 to 2 hours for the first 48 hours.
  • If there is still tenderness after 48 hours, apply a warm compress every 1-2 hours.
  • Take acetaminophen for pain. Do not take aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen because they can cause or increase bleeding.

Medical Treatment

Many eye injuries are minor and will heal within two weeks with basic first aid. There is always the risk of more serious consequences, so you should still see an eye doctor immediately, even if you have no symptoms. This is especially urgent if a blow to the eye causes blood to appear in your eye, loss or change in vision, double vision, inability to move the eye normally, or severe pain in your eyeball. Depending on the extent of your injury, your doctor may provide further medical treatment. For instance:

  • If the skin around your eye is cut, you may need stitches.
  • If there was any damage to the eye itself, you may need antibiotic eye drops to prevent infection.
  • Your doctor may prescribe eye drops to minimize inflammation.
  • If there is suspicion of damage to the bones, x-rays or other imaging may be performed
 

Prevention    TOP

To help reduce your chance of an eye contusion:

  • Wear protective eye covering such as safety goggles whenever the eye is exposed to potential injury at work or play. The best goggles fit snug against the skin so that no foreign objects can get underneath the goggle and into the eye.
  • Avoid situations that may involve fighting.

Special Note on Domestic Violence

Many cases of black eyes are the result of domestic violence. If you suffer from any form of domestic violence, verbal or physical, talk to your doctor or call a domestic violence hotline right away. Do not feel alone or threatened. There is help available.

RESOURCES:

Eye Smart—American Academy of Opthalmology
http://www.eyesmart.org

National Domestic Violence Hotline
1-800-799-SAFE (7233) or 1-800-787-3224 (TTY)
http://www.ndvh.org

CANADIAN RESOURCES:

Canadian Ophthalmological Society
http://www.eyesite.ca

Public Health Agency of Canada
http://www.phac-aspc.gc.ca

REFERENCES:

American Academy of Ophthalmology. Preventing Eye Injuries: A Closer Look. 2004.

Beers MH, Berkow R, et al, eds. The Merck Manual of Diagnosis and Therapy. Whitehouse Station, NJ: Merck Research Laboratories; 1999.

Contusion. EBSCO DynaMed website. Available at:
...(Click grey area to select URL)
Updated January 31, 2014. Accessed August 27, 2014.

Eye injuries. Nemours Kids Health website. Available at
...(Click grey area to select URL)
Updated January 2011. Accessed August 27, 2014.

Johns Hopkins University. The Johns Hopkins Family Health Book. New York: Harper Collins Publishing; 1999.

What is a black eye? American Academy of Ophthalmology Eye Smart website. Available at:
...(Click grey area to select URL)
Accessed August 27, 2014.



Last reviewed June 2014 by Fabienne Daguilh, MD
Last Updated: 5/11/2013

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