Black eyes typically occur after a blow or blunt trauma to the eye or the nose, often causing one or both eyes to swell due to the nasal injury causing fluid to collect in the thin, delicate tissues of the eyelids. Facelifts, jaw surgery, head injuries, or nose surgery may also result in black eyes. When both eyes are black and blue and swollen they are often referred to as “raccoon's eyes.” (Raccoon eyes are also a sign of a type of skull fracture, so any raccoon eyes without eye trauma need to be checked out for a skull fracture.) Symptoms of black eyes are predominantly pain, bruising, and swelling. At first the swelling and discoloration may be mild, the color slightly reddened, progressing to a darker shade. As the area heals, the skin around the eye may turn a deep violet, yellow, green, or black in color, which lightens after a few days as the swelling goes down. A black eye may result in some temporary blurry vision or difficulty opening the eye because of the swelling, but lasting, serious visual problems aren't common. A black eye may be accompanied by a headache due to the blow to the head or face that caused the injury. Serious signs to watch for and report to your doctor are double vision, loss of sight, any loss of consciousness, loss of ability to move the eye, any blood or clear fluid from the nose or the ears, blood on the surface of the eye, and persistent headache.

First Aid for Black Eyes

First aid for black eyes includes the following:

• Apply ice packs immediately after the injury in order to help decrease the swelling and pain.

• Try to rest as much as possible.

• Sleep with the head of your bed elevated.

Use the packs for twenty minutes of every hour you are awake during the first twenty-four hours. Be careful to wrap the ice; never apply ice directly to the skin or any area of the body. You can also use a bag of frozen vegetables wrapped in a cloth.

Stay away from all activities that may reinjure the area until after the eye has healed. Although most black eyes heal without complications, you should see an ophthalmologist to make sure that no significant injury has occurred to your eye. In addition, call your doctor for any of the following:

• Changes in vision

• Severe pain continues

• Swelling is not related to an injury

• Signs of infection such as warmth, redness, or pus-like drainage

• You are unsure about treatment or concerned about any symptoms

• You have any behavioral changes The swelling doesn't start to improve after a few days You have any swelling near the eye from a bee sting.

Go to the emergency room or your doctor immediately for any of the following:

• Changes in or loss of vision

• Inability to move your eye

• You think an object pierced your eye or is inside your eyeball

• There is any blood in your eye

• Your eye looks deformed or has fluid leaking from it

• Any cuts (lacerations) to your eye area, face, or head

You also need to go to an emergency department if you have signs of a serious head or facial injury such as:

• Broken bones or teeth

• Vomiting after the injury

• You are not able to walk after the injury

• You have blood or clear fluids coming from your nose or ears

• You take blood thinners

• You have a history of bleeding problems such as hemophilia