Black Eye (periorbital haematoma): Causes, Symptoms, Risk Factors and Treatment

Published on May 12th, 2023

Updated on June 19th, 2024

A black eye, or a periorbital haematoma, is an area of skin around the eye that is bruised or discoloured. This article will explore the black eye definition, black eye symptoms, black eye causes, black eye risk factors and black eye treatments. A black eye can have a range of causes, the most common being a hit or blow to the face that causes trauma or injury. Other causes of a black eye may include surgery and allergies. The symptoms of a black eye include bruising or discolouration around the eye area and swelling. Treatment for a black eye should be undertaken at the recommendation of a healthcare professional, though people may be able to relieve symptoms such as swelling at home with a cold compress. The risk factors for a black eye include playing contact or collision sports.

A black eye can be a sign of a serious medical issue. It is important to seek medical attention if you have a back eye.

What is a Black Eye?

A black eye is a general term that refers to bruising around the eye. The medical term for a black eye is a periorbital haematoma. According to the American Academy of Ophthalmology, a black eye is commonly caused by an injury or trauma to the face, usually near or around the eye. If the area around the eye is injured, it may break the small blood vessels under the skin, leading to the bruising or discoloration around the eye. The tissue in this area will also fill with blood and fluid, causing swelling of the skin.

What are the Other Terms for Black Eye?

The other terms for a black eye include the scientific term as well as the colloquial term. The scientific term for a black eye is a periorbital haematoma. The colloquial term for a black eye is a shiner.

How Does a Black Eye Develop?

A black eye will commonly develop due to trauma or injury to the face and eye area, which leads to a buildup of blood and fluids in the surrounding tissues. According to Health Direct, Australia’s virtual public health information service, the build-up of fluid in the eye tissues as well as broken blood vessels underneath the skin will cause swelling, black or bluish discolouration of the skin or a black-looking eye. A black eye may also develop as a result of allergies, in which the congestion and swelling makes it difficult for blood to drain from the face.

What are the Causes of a Black Eye?

The causes of a black eye include a knock to the face, contact or collision sports, surgery, a skull fracture, and allergies or sinus infections. What causes black eyes to form is swelling and discolouration of the skin, which has many causes such as trauma or injury to the facial area, or congestion from allergies. The causes of a black eye are listed below.

Knock to the face: A knock to the area surrounding the eye may lead to swelling and bruising, or a black eye.
Contact or collision sports: Contact sports such as basketball and collision sports such as rugby, where a person is in constant contact with other people or objects, receiving knocks to the head and face, can often cause black eyes.
Surgery: Certain surgeries that focus on the face, such as dental surgery or rhinoplasty can cause a black eye due to trauma they may have on the facial structures.
Skull fracture: Trauma from a skull fracture around the eye may cause a black eye.
Allergies or sinus infections: Allergies or sinus infections may cause a black eye due to nasal congestion and the pressure it can cause around the eyes.

1. Knock to the Face

A knock to the face is a common cause of a black eye as forceful contact with the face can cause injury or trauma, leading to swelling and discolouration of the skin around the eye. A knock to the area refers to a knock, a hit, or a blow to the face or head. A knock to the area surrounding the eye can cause a black eye as it may cause injury or trauma, which leads to swelling and bruising and a black eye. A knock to the eye can be caused by a number of situations including an accident such as walking into something, falling onto the face, or following a fight where a person is hit in the face.

2. Contact and Collision Sports

Contact sports and collision sports such as basketball, rugby, ice hockey and boxing, are common causes of black eyes as the force of contact in these sports can cause injury to the eye area. According to Gillette Children’s medical organisation, contact sports refer to sports such as basketball in which a person is in regular contact with other people as part of the game. Collision sports refer to sports such as ice hockey, boxing and rugby when people come into contact with each other with significant force, including being punched during boxing or tackled in rugby. In Australia, AFL and rugby league are considered collision sports, according to Monash University. Contact and collision sports are common causes of a black eye as constant forceful contact with other people in the form of tackles or punches, can cause trauma to the face and the areas surrounding the eye, leading to a black eye.

3. Surgery

Surgery may cause a black eye if the surgery carried out has a focus on the facial structures, especially near the eyes, such as rhinoplasty. Surgery refers to a procedure to treat medical conditions, often by invasive means such as cutting into the tissue. Surgery may also be cosmetic in nature. According to Health Direct, surgeries that may cause a black eye include dental surgery, nasal surgery, and cosmetic surgery, such as a rhinoplasty or a nose job. Surgery can cause trauma to the area surrounding the eyes which can lead to swelling and bleeding under the tissues near the eye, causing a black eye. For instance, people who have a rhinoplasty or a nose job often suffer from black eyes due to the trauma to the nasal area during this procedure which may cause bleeding under the skin and swelling.

4. Skull Fracture

A skull fracture may cause a black eye if it occurs near the eyes. According to the American Academy of Ophthalmology, a skull fracture may also cause a black eye if blood from nearby fractures leaks into the tissue near the eyes. A skull fracture is defined as a fracture or breaking of the skull or the cranial bones, according to Cedars-Sinai, a Californian healthcare organisation. A skull fracture may cause a black eye if it occurs on the cranial bones near the eyes, such as the eyebrows or bones below the eyes. This is called an orbital fracture. The fracturing of the bones around the eyes can cause swelling and bleeding in the tissue near the eye, causing black eyes. A skull fracture can also cause a black eye if the blood that has been caused by a less localised, nearby fracture leaks into the tissues near the eyes, causing bruising and discolouration.

5. Allergies or Sinus Infections

Allergies or sinus infections may lead to a black eye as the pressure these conditions cause around the eye area can result in swelling and dark discolouration around the eyes. Allergies are defined as an immunological reaction in which the body’s immune system releases a substance called histamine, to help fight what is perceived to be an allergen, such as pollen or animal dander. Sinus infections are defined as infections that affect the sinuses, which are cavities or spaces in the face that connect to the nose, according to Cambridge Dictionary. Both allergies and sinus infections can cause congestion, which is a build-up of fluid or mucus in the nasal passages. Congestion can cause a stuffy or full feeling in the nose. If congestion is particularly bad, it can cause pressure and swelling around the nose and the eyes. According to Medical News Today, the swelling of the eye area may make it hard for blood to drain from the veins in the face, leading to skin discolouration under the eye, or a black-looking eye. Black eyes that are caused by allergies are referred to as allergic shiners.

What are the Symptoms of Black Eye?

The symptoms of a black eye include pain around the eye, swelling around the eye, discolouration, and a headache. The most common symptoms of a black eye are black and bluish discolouration of the tissue around the eye and swelling of these tissues. However, symptoms may vary depending on what caused the black eye. The possible black eye symptoms are listed below.

Pain around the eye: If a black eye has been caused by trauma to the face or the area around the eye, a dull or achy pain around the eye can be an indication a black eye may develop.
Swelling around the eye: Swelling around the eye is a common symptom of a black eye and is caused by the body’s inflammatory response, which tries to heal the injured or infected part of the body.
Discolouration: Discolouration is the most common symptom of a black eye and refers to the blue or black bruising around the eye, giving the condition its colloquial name.
Headache: If a black eye has been caused by injury to the face, or allergies, a headache may be a symptom of a black eye.

1. Pain Around the Eye

Pain around the eye can be a symptom of a black eye if there has been an injury or trauma to the eye area. Pain around the eye refers to a dull, or achy feeling around the eye area, including the eyebrow, nasal and cheekbone areas. Pain around the eye may be a symptom of a black eye if a person has been hit in the face, or suffered another injury or type of trauma to the face. Pain around the eye may be accompanied by swelling, then bruising, causing a black-looking eye.

2. Swelling Around the Eye

Swelling around the eye is a common symptom of a black eye if the black eye is caused by an injury, infection or allergies, in which the tissues swell as a result of the inflammatory response. Swelling refers to a part of the body becoming enlarged due to illness or injury, according to Cambridge Dictionary. Swelling is part of the body’s inflammation response, which is deployed to help heal areas of the body that have been injured or are sick. Swelling around the eye looks like red or puffy skin around the eyes or an enlargement of the tissues around the eye. Swelling around the eye can be a symptom of a black eye if the black eye is caused by an injury or infection around the eye or allergies. According to Britannica, infection or injury around the eye may trigger the inflammatory response in the body that helps to heal the affected tissues by removing the damaged tissue. Swelling around the eye may blur the vision temporarily, but this should revert back to normal after the swelling goes down. If you have blurred vision alongside a black eye, it is important to seek medical attention.

3. Discolouration

Discolouration is the most common symptom of a black eye and is what gives the condition its colloquial name. Discolouration in regards to a black eye refers to the black and bluish colour that is visible in the tissues around the eye. Discolouration around the eye is caused by a breaking of the small blood vessels underneath the skin, leading to this black, bluish bruising. In the case of allergic shiners, discolouration of the tissues around the eye is caused by congestion-induced swelling that stops the blood from draining from the face.

4. Headache

If a black eye is caused by an injury or trauma to the face, it may cause a headache. A headache may also be a symptom of a black eye if the black eye is caused by allergies or a sinus infection, as the pressure and inflammation from congestion may lead to a sinus headache. Headaches may feel like a sharp pain or a throbbing sensation in the head and the face. Headaches can be felt in many different places, including behind the eyes and in the sinus areas. A headache may be a symptom of a black eye if the black eye has been caused by injury, trauma to the eye area, an allergic shiner or sinus infection.

If a headache that occurs alongside a black eye is painful or persists, it is important to seek medical attention as soon as possible.

When Should You Seek Medical Attention for Your Black Eye?

It is important to seek medical attention if you have a black eye. Though black eyes are sometimes a minor case of bruising, they can also indicate a more serious medical issue, meaning you should see a medical professional as soon as possible to receive the appropriate treatment. There are several indicators that suggest a black eye is part of a more serious medical condition that requires treatment including blurred vision, double vision, vision changes, light sensitivity or seeing flashes of light, eye pain, persistent headaches, bleeding in the eye, or if you lost consciousness when you got the black eye. The serious symptoms of a black eye that indicate a person may need immediate medical attention are listed below.

Blurred vision: Blurred vision may be caused by a black eye swelling, but can also be caused by trauma to the eye. Blurred vision in conjunction with a black eye requires immediate medical assessment.
Double vision: Double vision refers to a person seeing two images of the same object. If a black eye has been caused by an injury or trauma to the face or head area, double vision may be an indicator of a more serious medical condition and requires immediate medical attention.
Vision changes: Vision changes such as decreased vision and eye floaters, or spots in vision, alongside a black eye may indicate a more serious medical condition like a concussion or injury to the eye, requiring medical attention.
Light sensitivity or flashes of light: If the cause of a black eye is an injury or trauma to the face, this may also injure the eye itself, leading to possible light sensitivity or flashes of light. Any changes to vision require immediate medical attention so the appropriate treatment can be given.
Eye pain: Severe pain in the eye or around the eye area, is a black eye symptom that requires immediate medical attention as it may suggest a problem with the eye itself, or the surrounding areas, such as a fractured eye socket.
Persistent headaches: A black eye that is caused by trauma or injury to the face may cause a headache. If the headache that accompanies a black eye is severe and persists, it is important to seek medical attention as this may suggest a more serious medical condition.
Bleeding in the eye: Bleeding from the eye, inside the eye or on the surface of the eye, in conjunction with a black eye, can indicate a serious medical condition such as damage to the eye. It is recommended to seek medical attention as soon as possible.
Loss of consciousness: According to Health Direct, a person who has lost consciousness whilst sustaining the injury or trauma that led to a black eye should seek immediate medical attention, as this can be an indication of a serious medical issue.

Can a Black Eye Indicate a More Serious Underlying Condition?

Yes, a black eye can indicate a more serious underlying condition. If a black eye has been caused by an injury or trauma to the eye or area around the eye, a black eye, in conjunction with other symptoms such as bleeding in the eye, eye pain, persistent headaches, light sensitivity, vision changes or a loss of consciousness when receiving the black eye, can indicate a more serious medical condition. It is important to seek medical attention if you have a black eye, especially in conjunction with these serious symptoms.

When Do Black Eye Symptoms Usually Occur?

The most common black eye symptoms which are bruising and swelling around the eye, may start to develop 1 to 2 days from the time of the injury or trauma to the face that has caused the black eye. This time may change depending on the exact cause of the black eye. According to Health Direct, the blue or black discolouration around the eye will generally fade to a green or yellow colour after a few days.

Will a Black Eye Lead to Any Complications or Long-term Eyesight Issues?

A black eye may lead to complications or long-term eyesight issues, depending on the cause of the black eye. A black eye that is the result of an injury or trauma to the area around the eye, may lead to complications if the eye has been damaged or the injury is severe. Black eyes that are caused by allergic shiners will not generally have any complications or long-term sight issues. It is important to seek medical attention for a black eye to receive the appropriate treatment and avoid any complications.

How Long Until a Black Eye Is Healed?

The healing time for a black eye is dependent upon what has caused the black eye and how severe the black eye is. Generally, it will take 2 weeks for the black eye bruising or discolouration to fade, as the blood is reabsorbed into the body, according to Health Direct.

Does a Black Eye Naturally Disappear?

Yes, a black eye will generally disappear naturally. The bruising or discolouration that gives a black eye its name, is the result of small blood vessels under the skin breaking from trauma or injury, which leaks blood into the skin. The body will naturally reabsorb the blood back into the body during the healing process.

What are the Risk Factors of Black Eye?

The risk factors for a black eye include playing contact or collision sports, having surgery on areas of the face and working in high-risk workplaces such as building sites. The possible risk factors of a black eye are listed below.

Playing contact or collision sports: According to Health Direct, Australia’s virtual public health information service, a hit to the face that causes injury or trauma is one of the most common causes of a black eye. This means that people who play contact or collision sports, such as soccer and rugby, are at a higher risk of getting a black eye. People who play contact or collision sports are often in forceful contact with others, which may lead to injury or trauma to the face and head, possibly resulting in a black eye.
Surgery to areas of the face: People who have facial surgery, such as a nose job are also at a higher risk of getting a black eye as this may cause trauma to the area around the eye, resulting in a black eye.
High-risk workplaces: You may be at risk of a black eye if you work in an environment where you may have unexpected objects come into contact with the facial area, such as building sites.

What are the Black Eye Complications?

The complications from a black eye mainly revolve around potential vision damage if the black eye has been caused by trauma or injury to the eye area. If the eye has been damaged, it may lead to vision issues such as hyphema and retinal detachment, which can threaten sight. It is important that you seek medical attention for a black eye to prevent any complications that may affect your sight. Some of the potential black eye complications are listed below.

Hyphema: If a black eye has been caused by trauma to the eye such as a hit or a blow, this may lead to hyphema. Hyphema refers to blood collecting at the front of the eye. A hyphema can lead to vision issues if not treated.
Retinal detachment: If a black eye has been caused by trauma to the eye area, this trauma may cause retinal detachment in serious cases. A retinal detachment requires urgent care as it is a very severe eye condition. Symptoms of retinal detachment include the sudden appearance of blurred vision, flashes of light, eye floaters, and a gradual diminishing of peripheral vision.

How is Black Eye Diagnosed?

A black eye will be diagnosed by a healthcare professional, such as a doctor, a nurse or an emergency service worker. The medical professional will assess the eye and determine the cause of the black eye and how to treat it.

Where can you seek Black Eye Diagnosis?

You can seek a diagnosis for a black eye from a medical professional, at a doctor’s office, or at the hospital, such as the emergency room.

What are the Treatments Available for Black Eye?

The treatment available for a black eye will be dependent upon the cause of the black eye. If the black eye has been caused by trauma or injury to the face, a medical professional will recommend the appropriate treatment. If the black eye is caused by allergies, known as an allergic shiner, then allergy medication and decongestant medication may help ease the congestion and swelling that is causing the black eye. You should always consult with a healthcare professional before taking any medication.

At-home treatment methods for a black eye can include pain relief and icing the area with a cool pack to relieve symptoms of redness and swelling. A black eye should only be treated at home after consultation with a healthcare professional.

What are the Home Remedies and Treatments for Black Eye?

The home remedies or treatments for a black eye should only be used after consultation with a healthcare professional. The home remedies for a black eye revolve around reducing inflammation and managing pain. The home remedies or treatments for a black eye include icing and over-the-counter pain relief.

Icing the area around the eye: Icing the eye area using a cold compress can be used as a home treatment for a black eye. Icing involves taking an ice pack wrapped in a towel or using cold compress, such as a cloth soaked in cool water, and applying it to the affected area. Icing or using a cold compress can help reduce swelling and inflammation and promote healing for a black eye.
Over-the-counter pain relief: If the black eye is causing pain, over-the-counter medication may be used to help relieve this pain. You should always consult with a healthcare professional before taking any medication. Do not stop or start medication without first consulting with a healthcare professional.

Will Certain Drugs or Supplements Worsen a Black Eye?

A pharmaceutical drug or medication that can make a black eye worse is aspirin. Aspirin is a type of medication that thins the blood and helps it to clot. Aspirin can make it easier for the skin to bruise, according to Health Direct, and may worsen the bruising of a black eye. If you have a black eye and are taking aspirin, consult a healthcare professional for advice on forms of treatment and pain relief.

Can Eye Drops Treat a Black Eye?

Eye drops are not a common treatment for a black eye, as the main symptoms of a black eye are discolouration and swelling around the eye, not in the eye, which is the area that eye drops are commonly used. Eye drops are a type of medication that is applied to the surface of the eyes in liquid form, via an eye dropper.

How to Prevent a Black Eye?

A black eye may be prevented in certain situations such as on a worksite or whilst playing sports. A black eye that is caused by injury or trauma to the face during contact or collision sports such as boxing or rugby, may be prevented by wearing headgear. Headgear is a type of coverage that covers the head, which can help to prevent direct contact with the head. A black eye may also be prevented by wearing protective glasses on worksites, such as building sites, to help prevent debris from entering and injuring the eye.

Does Wearing Protective Glasses Prevent a Black Eye?

Yes, wearing protective glasses may help to prevent a black eye if a person is working on a building site, or other workplaces in which there are objects or debris, that may cause injury if contact is made with the face or the eye area.

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