Black Eye: What to Do at Home and the Red Flags to Watch For
A black eye is a bruise of the skin around the eye, and most heal on their own in a couple of weeks with a cold pack and rest. The part that matters is the eye itself and the head behind it. Changed vision, double vision, blood in the eye, vomiting or a blow to the head turn a “simple bruise” into an emergency.
Black eye at a glance
- First day or two: a cold pack wrapped in cloth on the bone around the eye, 10 to 20 minutes at a time. Never press on the eyeball.
- After 2 days: a warm cloth can help the bruise fade.
- Usual healing time: about 2 to 3 weeks. See a doctor if it has not gone in 3 weeks.
- Emergency signs: blood in the eye, double or lost vision, an odd shaped pupil, vomiting, a head blow or an eye that will not move.
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What should you do for a black eye at home?
The bruise is blood that has leaked under the thin skin around the eye. The skin there is loose, so a small bleed spreads and swells quickly. The aim of first aid is to limit that swelling and keep the eye safe from pressure.
- Check the eye first. Can you see normally, move the eye in all directions and does the pupil look round? If anything is off, skip home care and read the red flags below.
- Use something cold. A bag of frozen peas or an ice pack wrapped in a clean cloth works well. Hold it gently against the bone around the eye, not on the eyeball, for 10 to 20 minutes. Repeat regularly through the first day or two. The NHS gives this advice.
- Keep the head up. Rest with your head raised on extra pillows, which may reduce swelling. If there was any head injury, check with a doctor before relying on this.
- Do not press, rub or squeeze. Pressure can hurt the eye.
- After two days, switch to a warm, not hot, cloth a few times a day. The warmth helps the blood clear.
Try this: the frozen peas trick
A bag of frozen peas moulds itself to the curve of the eye socket better than a hard ice block. Wrap it in a thin cloth, never put it straight on skin, and keep it on the bony rim. Stop the pack if the skin turns very pale or numb. A tight, wrapped flat cold pack should never touch the eyeball itself. If the blow came with a knock to the head, ask a doctor before settling in at home.
What are the red flags after a hit to the eye?
The skin is the least worrying part. A hard blow can fracture the bones around the eye, bruise the eyeball, cause bleeding inside it or injure the head. These signs mean go to emergency care now, and do not drive yourself:
- Blood visible in the eye, such as a red layer in front of the pupil.
- Double vision, blurred vision, loss of vision, flashing lights or shadows.
- An irregularly shaped pupil.
- Inability to move the eye, or the eye looks sunken or pushed forward.
- Severe pain, or pain when looking at bright light.
- A headache that will not go, vomiting, drowsiness or confusion.
- Bruising around both eyes after a blow to the head, or any loss of consciousness.
- A cut near the eye, or something stuck in the eye.
If the injury came from a cricket ball, a stick or a firework, jump straight to our guide on eye injury first steps. Chemical or dust in the eye is a different problem, covered in safe flushing. Sudden blur in one eye with no injury is a separate emergency, described in sudden blurred vision in one eye.
How do you tell a black eye from allergy puffiness?
A black eye follows a knock, goes purple, blue, then green or yellow over days and is tender to touch. Allergy or morning puffiness comes without a blow, looks swollen and pale or pink, and usually itches rather than hurts. If you have swelling without an injury, see puffy eyes in the morning. Dark circles that appear after a sneeze or cough may be a small broken blood vessel. Sudden swelling with severe pain, headache and a red, hard eye is a different story and should be treated as urgent, as in painful red eye and headache.
Children, sports and falls in older adults
Children often fall face first, and a black eye after a playground bump is common. Look carefully for the red flags above and take a child under 5 to a doctor if you are worried, as the NHS advises calling 111 for children under five with an eye injury. In sports, protective eyewear is the long term answer: a ball or elbow can be hard enough to hurt the eye itself.
Older adults who fall should be checked more carefully, especially if they take blood thinning medicine. A black eye after a fall may be a sign of a head injury, and the NHS advises urgent help for anyone on a blood thinner such as warfarin or with a bleeding disorder. Do not stop or change any medicine without the doctor who prescribed it. If a child or older person has repeated unexplained bruising, speak to a doctor.
Pain relief and what to avoid
For pain, the NHS says ordinary painkillers can be taken as the pack directs, and that aspirin should be avoided unless a doctor prescribes it, as it can worsen bruising. Ask a pharmacist if you are unsure what is safe for you. Do not use eye drops, home pastes, raw meat, hot compresses in the first two days or massage. None of these help a bruise. For more on keeping eyes safe, see Eye Care.
The bruise is the visible part. The eye and the head behind it are what you are really checking.
Treat any change in vision, double vision, blood in the eye, a misshapen pupil, a headache that will not shift, vomiting or drowsiness as an emergency, and go to hospital with someone else driving. Take urgent advice if you take blood thinning medicine, have a bleeding problem, or have warmth, pus or fever with the swelling, which may mean infection. A black eye that has not faded in 3 weeks needs a doctor. Never press on the eyeball or try to open a swollen eye forcefully. If the injury was caused by another person or you feel unsafe at home, you deserve support, and a doctor can help.
Frequently asked questions
What is the best home care for a black eye?
A cold pack wrapped in cloth on the bone around the eye for 10 to 20 minutes at a time for the first day or two, then warm cloths. Keep the head raised and do not press the eyeball.
How long does a black eye last?
Usually about 2 to 3 weeks, changing colour as it fades. See a doctor if it is still there after 3 weeks.
When should I see a doctor for a black eye?
Straight away for vision changes, double vision, blood in the eye, severe pain, vomiting or a head blow. Also if you take blood thinners.
Should I use an ice pack for a black eye?
Yes, wrapped in cloth and placed on the bone around the eye, not on the eyeball. Frozen peas work well.
Why is a black eye after a fall in the elderly serious?
It may mean a head injury or bleeding, particularly if they take blood thinners. They should be checked by a doctor promptly.
Is a black eye with headache and vomiting an emergency?
Yes. Together with a blow to the head they can signal a head injury, and emergency care is needed.
Can a black eye affect vision?
The bruise itself does not, but swelling may block sight temporarily. Blurred, double or lost vision can mean damage inside the eye and needs urgent care.
Can you get a bruise under the eye after sneezing?
Occasionally a small blood vessel breaks. It usually fades alone, but swelling with pain or vision change should be checked.