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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 result when a blow happens in or near the eye socket. If a bruise appears, it will usually do so within 24 hours of the injury.
    Eyelid Contusion
    Nucleus Image
    Copyright © Nucleus Medical Media, Inc.
  • Causes

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

    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

    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

    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

    First-aid Treatment
    It is important to apply first-aid treatment right away.
    • Seek emergency medical attention right away if there is any concern that the eye has been injured.
    • 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 2 weeks with basic first aid. There is always the risk of more serious consequences, so you should consider seeing an eye doctor right away, even if you have no symptoms. This should be done urgently 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 swelling.
    • If there is suspicion of damage to the bones, x-rays or other imaging may be performed
  • Prevention

    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 eye coverings fit snug against the skin so that no foreign objects can get underneath them 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.

    Eye Smart—American Academy of Opthalmology

    National Domestic Violence Hotline1-800-799-SAFE (7233) or 1-800-787-3224 (TTY)


    Canadian Ophthalmological Society

    Public Health Agency of Canada


    Eye injuries. Nemours Kids Health website. Available at Updated September 2014. Accessed May 6, 2016.

    What is a black eye? Eye Smart—American Academy of Ophthalmology website. Available at: Updated March 1, 2015. Accessed May 6, 2016.

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