The appearance of bruising around the eyes because of an injury to the head or the face is referred to as a black eye.  

Often, a black eye isn’t a serious eye condition. A minor injury, such as a scratch, can cause fluids and blood to build-up in the skin around the eye. It causes the tissue to swell and bruise. The tissues may need one to three weeks to return to normal color. The time duration is dependent on the amount of blood and fluid that have collected within the skin. 

A black eye may appear following surgical procedures such as a facelift or nose surgery. 

At times, a black eye could be an indicator of a medical emergency like bleeding in the eye (hyphema) or a skull fracture. 

Where the disorder affects both eyes following a head injury, it could mean a severe injury such as a skull fracture. Raccoon eyes are a term used to refer to blood that accumulates under the eyes. It is linked to a fracture in the base of the skull.

Also Known As

  • Eye bruises 
  • Bruising around the eyes
  • Shiner
  • Ecchymosis

Causes and Risk Factors

In most cases, eye bruises are caused by trauma to the face or head, which leads to bleeding under the skin. The small blood vessels under the skin break and blood leaks into the nearby tissue. It causes bruising or discolorations. 
Risk factors include:

  • Contact sports
  • Hazardous occupations
  • Some outdoor activities
  • Cluttered places
  • Slippery floors and stairs
  • Aggressive family members

Signs & Symptoms

Symptoms for a black eye include:

  • Blurred vision
  • Discoloration around the eye
  • An increasing swelling around the eye
  • Pain around the eye

One needs to differentiate between black eye symptoms and those that may signify a severe head injury.
Warnings of a severe head injury include:

  • Fainting or loss of consciousness
  • Blood on the eyeball surface
  • Vision loss
  • Headache
  • Vomiting
  • Double vision
  • Dizziness
  • Memory lapses
  • Inability to move the eye
  • Nausea
  • Lethargy


The eye professional conducts a physical examination to diagnose a black eye. The professional asks about the injury and any other related injuries. Further, he/she checks the eyes and tests the patient’s vision.

In severe cases, the eye professional will conduct a comprehensive eye exam. An X-ray and CT scan of the patient’s face and head helps to diagnose a fractured skull.


Treatment focuses on promoting reabsorption of the blood from the tissue around the eye.

Medical Treatment

The eye doctor treats any injury that may threaten the patient's eye function or vision.

Surgical Treatment

In the case of a severe head or face injury, the patient is referred to a specialist.
This could be:

  • A neurosurgeon for a skull or brain injury 
  • An ears, nose, and throat (ENT) specialist
  • A plastic surgeon or other specialists 

Alternative Treatment

Alternative remedies include:

  • Arnica, a herbal remedy that may reduce the swelling.
  • Vitamins C and K may help to reduce the swelling and promote healing.

Home Care

Often, the disorder is a minor injury treated with self-care at home; cold and warm compress, rest, and pain medication.

The patient can apply an ice pack on the eye once every hour for 15-20 minutes. This helps to ease pain and reduce swelling on the first day.

On the second day, the patient should apply the ice five times every hour. A warm compress may help on the third day.

Prognosis/Long-term outlook

Bleeding in the eye can affect the individual’s cornea and vision. Also, the internal eye pressure may increase in some instances of eye or face trauma. The pressure can cause damage to the patient’s eye and vision loss.

Damaged blood vessels in the eye or a ruptured eyeball may cause more swelling and infection. The swelling can immobilize the patient’s eye and reduce vision.

Prevention/Follow Up

One should take measures that reduce the risk of traumatic injury, including a black eye. These measures include:

  • Protective gear for sports and activities that increase the risk to the face and head
  • Eyewear for hazardous and outdoor activities
  • Clean floor and stairs
  • Use of seat belts