Eye Contusion

(Black Eye; Blunt Eye Injury; Ecchymosis)

Definition

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

Eyelid Contusion

Causes

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

Risk Factors

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
Violence

Symptoms

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

Diagnosis

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

Treatment

First-aid Treatment

It is important to apply first-aid treatment immediately upon receiving an eye injury.

Seek emergency medical attention immediately.
Immediately apply ice or a cold compress for 15 minutes 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.
For pain, take acetaminophen. Do not take aspirin or nonsteroidal anti-inflammatory medications like ibuprofen because these drugs can cause or increase bleeding.

Medical Treatment

While many eye injuries are fairly 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, such as a fracture, x-rays or other imaging may be performed

If you are diagnosed with an eye contusion, follow your doctor's instructions.

Prevention

To help reduce your chance of an eye contusion, take the following steps:

Wear protective eye covering like safety goggles whenever the eye is exposed to potential injury at work or play. The best type of goggles are those that are snug up against the skin so that no foreign objects can get underneath the goggle and into the eye.
Avoid 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 immediately (see Resources below). Do not feel alone or threatened. There is help available.

RESOURCES:

American Academy of Opthalmology
http://www.aao.org

Eye Safety for Emergency Response and Disaster Recovery
National Center for Occupational Safety and Health
Centers for Disease Control and Prevention
http://www.cdc.gov/niosh/eyesafe.html

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

National Eye Institute
http://www.nei.nih.gov

CANADIAN RESOURCES:

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

Shelternet
http://www.shelternet.ca

Women's Services Directory
Ministry of Community Services, British Columbia
http://www.mcaws.gov.bc.ca

REFERENCES:

American Academy of Opthalmology. Preventing Eye Injuries: A Closer Look [brochure]. 2004.

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

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

Nemours Foundation website. Available at http://kidshealth.... . Accessed September 25, 2005.

Last reviewed September 2009 by Ronald Nath, MD
Last Updated: 9/30/09

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