Introduction
Periorbital hematoma is a bruise in the tissues around the eye. It develops when fluid collects around the eye and under the skin due to head or face injury. It is also called the black eye. The discoloration around the eyes is due to the bleeding from the ruptured blood vessels under the skin. In addition, the tissues may usually get swollen due to fluid accumulation beneath the skin.
What Causes the Black Eye?
A black eye is usually due to trauma or injury to the face or head causing breakage of small blood vessels under the skin, leading to bleeding. It can be due to sports injuries in both young and older people. Assault or accidents can be the leading cause in the elderly. It can also be due to severe and complicated underlying factors like skull bone fractures. Other reasons causing periorbital hematoma are:
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Dental surgery or procedures leading to fluid or blood accumulation around the eye.
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Surgeries like cosmetic or nasal surgery, where the blood moves slowly and settles around the eyes after the procedure.
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Infections of the sinus (cavities present within the skull bone).
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Infection around the eyes.
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Allergic conditions.
How Does Periorbital Hematoma Appear?
Due to the bleeding occurring underneath the skin, the color around the eyes will initially be bluish, blackish, or purplish. The amount of blood collected influences the recovery time and color changes. Over the period, the color fades to yellowish or greenish. The intensity will also fade over the course as the blood gets reabsorbed.
When Is a Black Eye Considered an Emergency?
The tissues usually get swollen, along with discoloration. In the elderly, the skin around the eyes is very loose and puffy. In such cases, periorbital hematoma may look even worse. Sometimes it may also accompany eye bleeding, which should be considered an emergency and treated immediately, as it may gradually affect the vision. It usually takes up to two weeks for the periorbital hematoma to heal.
A black eye can be a sign of a serious underlying injury. Sometimes bleeding within the eye or hyphema may be exposed as a black eye. It can affect the eye's cornea (the transparent part of the eye) and vision. The face or head injury may sometimes increase the pressure inside the eyeball. It can damage the eye and eyesight if not treated properly. In case of skull fracture or severe injuries, both eyes may turn black.
What Are the Symptoms of Periorbital Hematoma?
The symptoms of the black eye may include:
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Pain around the eye.
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Mild swelling around the eye.
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Prolonged swelling around the eye, making it hard to open the eye.
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Discoloration around the eye, ranging from red in the beginning, eventually getting darker and blackish.
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Blurred vision.
How to Diagnose Black Eye in Older People?
It is essential to consult the doctor if the person experiences the symptoms. The doctor will be able to diagnose the black eye by physical examination. In addition, tests will be conducted to check if any vision changes have occurred. The eye movements may also be tested by asking to move the eyes following the movements of the doctor's finger in front of the eyes. Examinations will be done to check for internal damages caused in the eyes. X-ray or computed tomography (CT) scans may be done to check for any underlying fractures.
How to Treat Periorbital Hematoma?
Usually, the black eye may not be a serious problem and may get better by itself. If it is not severe and is due to a minor injury, it can be treated by cold compress, rest, and over-the-counter medication.
Place a cold compress, like an icepack, a bag of frozen peas or vegetables, or an ice cube wrapped in cloth, as soon as possible for 15 to 20 minutes every hour for 24 hours. A cold compress may reduce swelling. Once reduced, a warm compress can be given to aid in the reabsorption of blood.
Painkiller medications like Ibuprofen or Acetaminophen can be taken for pain relief. Keep the eyes protected from further injuries and avoid activities where the eyes can be hit, like sports and strenuous activities, till it heals.
What to Do if Self-Care Does Not Work?
If eye pain and headache persist, it is necessary to seek medical help. Home remedies should improve the symptoms; if not, it is vital to consult an ophthalmologist. If vision changes occur, immediately consult the doctor. The serious signs of a periorbital hematoma include:
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Vision loss caused by swelling.
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Persisting eye pain and headache.
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Inability to move the eye.
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Blood on the surface of the eyeball or inside the eye.
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Bleeding from the eye.
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Nausea, vomiting, and dizziness.
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Trouble breathing nasally.
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Nose bleeding.
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Memory lapses.
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Fainting.
How to Prevent Black Eyes?
Older people may usually get involved in household activities. For example, they may find it interesting to get soaked in gardening works or farming. Therefore, it is essential to keep preventive measures in mind to protect the eyes. Use safety glasses or goggles whenever necessary. While doing sports activities, use protective eyewear. Considering the following ‘do nots’ will help.
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Do not be overactive.
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Do not apply too much pressure on the area.
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Do not apply heat initially before the swelling subsides.
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Do not resist relaxing and resting.
How Long Will It Take To Heal?
The time taken to heal depends on the severity of the underlying injury. It also depends on the age and health status of an individual. It may heal faster in a healthy individual and take longer for an older person. The healing period also depends on the rest and care given during that time. Usually, it will get healed in two weeks.
Conclusion
Black eye or periorbital hematoma can occur due to many reasons. It is essential to know the leading cause behind the black eye. Getting immediate medical help before even trying out the home remedies is required in case of a severe underlying injury. Taking rest and care is the key to rapid healing.
