Causes for Black Eye and When to Worry
A black eye usually results from direct impact to the area around the eye. The skin around the eyes is thin and delicate, and even a minor blow can rupture small blood vessels, causing blood to leak into surrounding tissues. Learn more about the causes for black eye and when to worry below
Common causes of black eyes:
- Trauma or injury
- Sports injuries (e.g., rugby, boxing, cricket)
- Falls, especially in children and the elderly
- Car accidents
- Being struck with an object
- Surgical procedures
- Cosmetic surgery, such as eyelid surgery (blepharoplasty)
- Nasal or sinus surgery
- Dental work, particularly upper jaw procedures
- Medical conditions
- Sinus infections or allergic reactions may cause swelling or discolouration around the eyes.
- Clotting disorders or blood-thinning medications (e.g., warfarin) can make bruising more prominent.
- Violence or abuse
- In cases of domestic or gender-based violence, black eyes may be a visible sign of deeper trauma. In South Africa, healthcare providers are trained to recognise and sensitively address such cases.
When to worry:
While most black eyes heal without intervention, certain signs may indicate a serious medical issue:
- Vision changes (blurred or double vision, loss of vision)
- Severe eye pain
- Blood visible inside the eyeball (hyphema)
- Bleeding from the nose or ears
- Clear fluid leaking from the nose (could indicate a skull fracture)
- Numbness in the cheek or upper lip (suggesting a facial fracture)
- Vomiting, confusion, or memory problems (suggesting a concussion)
Red flags in children:
- Unexplained bruising in non-mobile infants
- Repeated injuries or injuries inconsistent with the explanation
- These may raise concerns of child abuse, which requires urgent investigation.
Causes for Black Eye and When to Worry
If any of these warning signs are present, immediate medical attention is needed to assess for orbital fractures, brain injury, or internal eye damage.
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