Black eye

Black eye
ICD-10	S00.1
ICD-9	921.0

A black eye is bruising around the eye commonly due to an injury to the face rather than an eye injury. The name is given due to the color of bruising. Most black eye injuries are minor and will heal themselves in about one week. Trauma near the eyebrow or places not directly on the eye may make the eyelid go black.

The dramatic appearance (discoloration and swelling) does not necessarily indicate a serious injury. The fatty tissue along with the lack of muscle around the eye socket allows a potential space for blood accumulation with relatively minor injury. As this blood is reabsorbed, various pigments are released similar to a bruise, lending itself to the extreme outward appearance. Unless there is actual trauma to the eye itself, medical attention is generally not needed.

Eye injury and head trauma may also coincide with a black eye. Some common signs of a more serious injury may include:

• Double vision
• Loss of sight and or fuzzy vision
• Loss of consciousness
• Inability to move the eye or large swelling aroud the eye such as a hemotoma
• Blood or clear fluid from the nose or the ears
• Blood on the surface of the eye itself or cuts on the eye itself
• Persistent headache

Putting a raw steak on a black eye (an old wives' tale) has long been known to have no medicinal value; doing this will lessen the bruise, but not the inflammation. The practice is, however, a staple of popular culture, usually in a humorous context in movies and TV shows.

Treatment

To treat a black eye, use an ice pack. The cold keeps the swelling down and also reduces internal bleeding by constricting the blood vessels. Use the ice pack for the first 24 hours. If the eye is swollen shut, use ice for ten minutes every 2 hours. To avoid putting too much pressure on the eye, crush ice in a plastic bag and tape it to the forehead. A homemade ice pack can be made by mixing 2 parts water with 1 part alcohol in a nylon bag and freezing it. The bag will be flexible and will mold to the face, plus it won't sweat.

Boxing trainers use the same concept to treat a boxer's black eye injuries. Essentially they use an extremely cold small metal iron. Any cold piece of metal (quarters or dollar coins also work) can be used to control the hemorrhaging. A similar remedy can be used at home by applying a cold soda can intermittently (5 to 10 minutes of every 15 minutes) until ice can be applied. Be sure the can is clean and hold it lightly against the cheek. Never apply direct pressure to the eyeball.

Aspirin should not be used for those with a black eye. Since it acts as an anticoagulant, aspirin can prevent blood from clotting and may make the bruising and discoloration worse. If pain relief is necessary, try acetaminophen.

Don't blow your nose. If it was a severe blow that caused your black eye (something more than just bumping into a door), blowing your nose could cause the face to blow up like a balloon. Sometimes the injury fractures the bone of the eye socket, and blowing your nose can force air out of the sinus adjacent to the socket. The air gets injected under the skin and makes the eyelids swell even more. It also can increase the chance of infection. Keep the head elevated (sleep with a few extra pillows, for example) to help limit swelling and pooling.

On the second day following the injury, applying warm washcloths or compresses can help increase circulation to the injured tissue. This aids in the re-absorption of any leftover blood that has collected at the injury site, promoting healing.

In most other European languages, a black eye is referred to as a "blue" eye (e.g. Danish: Blåt øje, Dutch: Blauw oog, German: Blaues Auge, Swedish Blåtira, Norwegian Blåøye/blekkøye) or a "purple eye" (e.g. Spanish: Ojo morado). In French, the expression "oeil au beurre noir" is used, which literally translates as "black butter eye". In many eastern Asian languages a black eye is referred to as a "panda eye".