Black Eye Overview
A black eye, also known medically as periorbital haematoma, is a common injury where blood collects under the skin around the eye, causing bruising and discolouration. Despite its alarming appearance, most black eyes are not serious and resolve on their own within a week or two.
Black eyes are usually caused by blunt trauma to the face or head. The soft tissues around the eye absorb the impact, leading to swelling and a purplish-black bruise that often spreads downward due to gravity. While most cases are mild, some may signal underlying fractures or internal injury, especially if accompanied by vision changes, severe swelling, or bleeding from the nose or ears.
Common causes include:
- Punches or facial trauma during sports, falls, or physical altercations
- Accidents at home, work, or school
- Surgical procedures involving the face or sinuses
- Allergic reactions or sinus infections (in rare cases, mimicking bruising)
Symptoms of a black eye:
- Swelling around the eye
- Red, blue, purple, or black discolouration
- Tenderness or pain on touch
- Difficulty opening the eye due to swelling
- Blurred vision or eye watering (occasionally)
It’s important to note that the eye itself is usually not injured in minor cases. However, trauma severe enough to cause a black eye can sometimes result in:
- Orbital fractures
- Retinal damage
- Hyphema (bleeding inside the eye)
- Concussion
In South Africa, black eyes are a common presentation in emergency departments and clinics, particularly following domestic violence, sports injuries, or assaults. In such cases, healthcare providers may screen for abuse or additional injuries.
While black eyes often heal without treatment, it’s crucial to monitor for signs of a more serious injury and to seek medical attention if vision is affected or the swelling is extreme.
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