What Is It?

A black eye, or “shiner,” is a bruise around the eye. When an object strikes the eye, the force of the impact breaks delicate blood vessels in the eyelids and surrounding tissues. Blood collects under the skin, and causes a black or blue discoloration in the eyelids and around the eye socket. Because the skin around the eye is relatively thin and transparent compared to skin in other parts of the body, the black and blue color of a bruised eye may seem darker and more intense than bruises elsewhere.

Although many people associate black eyes with fighting and violence, in reality, only about 15 percent of eye injuries are caused by violent assaults. Most black eyes happen by accident — during contact sports, at work, in a car crash or while performing home repair projects. Men get about four times more eye injuries than women do, and the average patient is approximately 30 years old. The source of the injury is usually a blunt object — a baseball, a hammer, a rock or a piece of lumber — and the most frequent place of injury is the home. At one time, it was also common for eye injuries to occur in motor vehicle accidents, usually when a victim’s face struck the dashboard. However, the number of eye injuries caused by car crashes has decreased significantly because of airbags and the mandatory use of seat belts.

Almost 2.5 million traumatic eye injuries occur each year in the United States. Most black eyes are superficial injuries that cause no permanent damage to the eye or to the tissues that surround it. When vision changes after a blow to the eye, it is a warning sign that the injury may be more than a simple bruise. The force of the blow may have fractured the delicate bones that form the eye socket, or the structure of the eye itself may be damaged.

A black eye causes swelling and black-and-blue discoloration of the eyelids and soft tissues around the eye. There also may be redness and small areas of bleeding on the white of the eye and on the inner lining of the eyelids.

You usually can diagnose a black eye yourself based on your symptoms and whether your eye was struck.

Most of the swelling and discoloration go away within seven to 10 days after injury. The color of the skin around the eye will change over the course of recovery, typically showing green and yellow tones as the blood ages and is cleared from the tissue.

Almost all eye injuries can be prevented. To decrease your risk of eye injuries:

• Use appropriate protective eyewear at work. Studies have shown that face shields, goggles and other protective eyewear can reduce the risk of work-related eye injuries by more than 90 percent.



• If you are an athlete, ask an experienced ophthalmologist, optometrist or optician for help in selecting protective eyewear that is appropriate for your sport. Baseball and basketball cause the greatest number of eye injuries. When a baseball or basketball strikes the eye, there is a risk of more serious trauma, including fractures of the eye socket.



• If you are a parent, do not allow your child to participate in amateur boxing. The American Academy of Pediatrics opposes the sport of boxing for young people.



• Always “buckle up” when you ride in a car. Seat belts and shoulder harnesses help to protect your eyes, facial bones and upper body from dashboard impacts and other injuries, even if your car is equipped with airbags.



• For youth who play baseball, eye injuries can be reduced by using face masks and safety balls, various types of balls that cause less injury when they strike a person. They include rubber balls, tennis balls and special “reduced-impact” balls that have a softer core.

If you have a black eye, apply cold compresses to the injured eye for at least 15 minutes to help reduce pain, swelling and discoloration.

Most black eyes are no more dangerous than a simple bruise on your arm or leg. There are times, however, when a black eye can be a sign of a more serious problem, such as a fracture of the eye socket or an injury to the inside of the eye. Call your doctor immediately if your black eye is accompanied by any of the following symptoms:

• Decreased vision, blurry vision or double vision
• Difficulty turning the eye in any direction (looking up, down, right or left)
• Flashing lights or “floaters” (spots seen by one eye that travel with your field of view as you move your eyes)
• Abnormal position of the eye — the injured eye either “bulges out” of its socket or looks “sunken in”
• Numbness in your cheek or upper teeth on the same side as the injured eye, which can be a sign of nerve damage related to a fracture of the eye socket
• A cut on your eyelid or on the inside surface of your eye

The prognosis is excellent. An uncomplicated black eye heals without complications.

Diseases and Conditions Center

All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.