First aid – Black eye

Put raw meat on a black eye.  True or false?

In actual fact, putting raw meat on a black eye is more likely to cause an infection.

A black eye is a relatively common result of injury to the face or the head, caused when blood and other fluids collect in the space around the eye; swelling and dark discolouration result and hence, the name “black eye.”

Most black eyes are relatively minor injuries. Many heal on their own in a few days; however, sometimes they signify a more serious injury, even a skull fracture, particularly if the area around both eyes is bruised (raccoon eyes) or if there has been a head injury.

Sometimes there is an accompanying injury to the eyeball itself sufficient to cause bleeding inside the eye. Bleeding in the front part of the eye, called a hyphema, is serious and can reduce vision and damage the cornea.

Causes

The most common cause of a black eye is a blow to the eye or nose. Depending on where the blow lands, one or both eyes may be affected.

A blow to the nose often causes both eyes to swell because the swelling from the nasal injury causes fluid to collect in the loose tissues of the eyelids.

Surgical procedures to the face, such as a facelift, jaw or nose surgery can cause black eyes as well.

A certain type of head injury, called a basilar skull fracture, causes both eyes to swell and blacken. This condition is typically described as “raccoon’s eyes.”

Other causes of swelling around the eye include allergic reactions, bites, cellulitis (skin infection around the eye), angioedema (a hereditary condition causing swelling, usually around both eyes) and dental infections. However, these conditions do not make the skin turn black and blue around the eye.

Symptoms

• Pain and swelling are the most common signs and symptoms of a black eye.
  •   Initially, the swelling and discolouration may be mild. The eye often starts off slightly reddened then progresses to a darker shade.
  •    Ultimately, the skin around the eye becomes deep violet, yellow, green, or black in colour.
  •    Swelling increases as discolouration progresses.
  •     Over the course of a few days, the area becomes lighter and the swelling decreases.
• Although some blurry vision or difficulty when opening the eye may occur because of the swelling, more serious visual problems are less common.
• Headache may also be present, because the usual cause of a black eye is some sort of head injury.

Treatment

Black eyes generally heal within a few days, but the following can be useful:

• Using gentle pressure, apply a cold pack or a cloth filled with ice to the area around the eye. Ice helps to decrease swelling by constricting blood vessels, by decreasing fluid accumulation and by cooling and numbing the area.
• Take care not to press on the eye itself.
• Apply cold as soon as possible after the injury to reduce swelling and continue using ice or cold packs for 20 min/hour for 24 to 48 hours.
• If it does not improve, apply a warm compress once in two hours.
• Take paracetamol for pain relief.
• Avoid aspirin as these medications may increase bleeding.
• Avoid strenuous activity.
• Be sure there’s no blood within the white and coloured parts of the eye.

When to see a doctor

Seek medical care immediately if the patient experiences:

• Persistent headache
• Double vision
• Blurred vision
• Inability to move eye/eyes
• Blood on eye surface
• Blood/fluid issue from nose, ears
• Loss of consciousness
• Loss of sight
• Severe pain or bleeding in the eye or from the nose.

Unfortunately there is not much that can be done for the discolouration, the tell-tale sign, but it will fade over time.