• Eye Contusion

    (Black Eye; Blunt Eye Injury; Ecchymosis)

    Definition

    An eye contusion is a bruise around the eye, commonly called a black eye. It may occur when a blow occurs in or near the eye socket. If a bruise appears, it will usually do so within 24 hours of the injury.
    Eyelid Contusion
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    Causes

    After being struck in the eye or nose, blood leaks into the area surrounding the eye.

    Risk Factors

    Factors that increase your risk of eye contusion include:
    • Participation in high impact sports such as basketball, football, hockey, and boxing
    • Occupations that expose the eye to potential injury, such as manufacturing, construction, and athletics
    • Violence

    Symptoms

    A black and blue or purple mark will appear following the injury. There may also be redness, swelling, and tenderness or pain. After it begins to heal, the contusion may turn yellow.

    Diagnosis

    Eye contusions are diagnosed visually. Healthcare providers assume that the eye has been struck in some way. Most people are able to self-diagnose a contusion, but a doctor may confirm the diagnosis.

    Treatment

    First-aid Treatment

    It is important to apply first-aid treatment right away.
    • Seek emergency medical attention right away.
    • Immediately apply ice or a cold compress for 15 minutes to reduce swelling and minimize pain. Do not press on the eye itself. Repeat every 1 to 2 hours for the first 48 hours.
    • If there is still tenderness after 48 hours, apply a warm compress every 1-2 hours.
    • Take acetaminophen for pain. Do not take aspirin or nonsteroidal anti-inflammatory medications like ibuprofen because these drugs can cause or increase bleeding.

    Medical Treatment

    Many eye injuries are fairly minor and will heal within two weeks with basic first-aid. There is always the risk of more serious consequences, so you should still see an eye doctor immediately, even if you have no symptoms. This is especially urgent if a blow to the eye causes blood to appear in your eye, loss or change in vision, double vision, inability to move the eye normally, or severe pain in your eyeball. Depending on the extent of your injury, your doctor may provide further medical treatment. For instance:
    • If the skin around your eye is cut, you may need stitches.
    • If there was any damage to the eye itself, you may need antibiotic eye drops to prevent infection.
    • Your doctor may prescribe eye drops to minimize inflammation.
    • If there is suspicion of damage to the bones, x-rays or other imaging may be performed
    If you are diagnosed with an eye contusion, follow your doctor's instructions .

    Prevention

    To help reduce your chance of an eye contusion, take the following steps:
    • Wear protective eye covering like safety goggles whenever the eye is exposed to potential injury at work or play. The best type of goggles are those that are snug against the skin so that no foreign objects can get underneath the goggle and into the eye.
    • Avoid fighting.

    Special Note on Domestic Violence

    Many cases of black eyes are the result of domestic violence. If you suffer from any form of domestic violence, verbal or physical, talk to your doctor or call a domestic violence hotline right away. Do not feel alone or threatened. There is help available.

    RESOURCES

    American Academy of Opthalmology http://www.aao.org

    Centers for Disease Control and Prevention http://www.cdc.gov

    National Domestic Violence Hotline1-800-799-SAFE (7233) or 1-800-787-3224 (TTY) http://www.ndvh.org

    National Eye Institute http://www.nei.nih.gov

    CANADIAN RESOURCES

    Canadian Ophthalmological Society http://www.eyesite.ca

    Public Health Agency of Canada http://www.phac-aspc.gc.ca

    References

    American Academy of Ophthalmology. Preventing Eye Injuries: A Closer Look [brochure]. 2004.

    Beers MH, Berkow R, Burs M, eds. The Merck Manual of Diagnosis and Therapy . Whitehouse Station, NJ: Merck Research Laboratories; 1999.

    Contusion. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 27, 2011. Accessed March 20, 2013.

    Eye injuries. Nemours Foundation KidsHealth.org website. Available at http://kidshealth.org/parent/firstaid%5Fsafe/emergencies/eye%5Finjury.html . Updated January 2011. Accessed September 25, 2005.

    Johns Hopkins University. The Johns Hopkins Family Health Book . New York: Harper Collins Publishing; 1999.

    What is a black eye? American Academy of Ophthalmology eyeSmart website. Available at: http://www.geteyesmart.org/eyesmart/diseases/black-eye.cfm. Accessed March 20, 2013.

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