Black Eye: How to Treat It and Signs of a More Serious Injury

A black eye is bruising around the eye, and most heal on their own within two weeks. But the same blow that causes a black eye can sometimes damage the eye itself, fracture the eye socket or cause a head injury. Knowing what to look for is important.

Imagine catching an elbow to the face during a five-a-side game. Within an hour your eyelid is swollen and purple. It’s embarrassing but you can see fine. Then you notice that when you look up, you see double. That one symptom changes everything.

How to treat a black eye

• Hold a cold pack wrapped in a cloth gently against the area (not pressing on the eye) for 10 to 20 minutes, several times in the first day or two
• Sleep with your head raised
• Take paracetamol for pain
• After a couple of days, warm compresses may help the bruise fade
• Avoid blowing your nose hard if your face was hit

But when is it an emergency?

Go to an emergency department if you have:

• Changes in vision: blurring, double vision or loss of vision
• Blood inside the coloured part or white of the eye, or a misshapen pupil
• Difficulty moving the eye, or numbness of the cheek or upper lip
• Severe eye pain or something stuck in the eye
• Head injury signs: vomiting, drowsiness, confusion or severe headache
• Bruising around both eyes (“panda eyes”) or clear fluid from the nose or ears

Sources: NHS (Black eye), American Academy of Ophthalmology, Royal College of Ophthalmologists. This guide is for general information and does not replace advice from your own nurse, doctor or emergency services.