Periorbital Contusion (Black Eye) (Child)

A contusion is a bruise. A bruise around the eye is called a periorbital contusion. This is also known as a black eye. A black eye is often caused by a blow to the eye area. It's an injury to the skin around the eye, not to the eye itself.

Symptoms of a black eye include bruising, swelling, and pain. Your child's eyelid may not open easily because of swelling.

Cool compresses or cold packs help reduce swelling. Bruising may take a while to heal. In some cases, the cause of the black eye can injure the eye, too. If the eye has also been injured, your child may need to wear an eye shield for a week or more.

Because the injury was to your child's face or head, it's possible that they could have a mild brain injury called a concussion. Symptoms of a concussion can show up later. For this reason, you need to watch your child for concussion symptoms once you're home. These include:

• Headache
• Nausea or vomiting
• Dizziness
• Sensitivity to light or noise
• Abnormal sleepiness or grogginess
• Trouble falling asleep
• Personality changes
• Vision changes
• Memory loss
• Confusion
• Trouble walking or clumsiness
• Loss of consciousness (even for a short time)
• Inability to be woken up
• Refusing to nurse or eat (infants)
• Will not stop crying and cannot be consoled (infants)

The doctor may prescribe medicines for pain and inflammation. Follow all directions for giving these to your child.

Here are suggestions for general home care:

• Apply a cold pack wrapped in a thin, dry cloth to the injury. Do this for up to 15 minutes every hour while your child is awake. This is to help relieve swelling. Continue for 1 to 2 days or as directed.
• Babies ages 9 to 11 months. As often as possible, hold your child with their head higher than the heart for the first day. This is to help ease swelling.
• Children 12 months and up. Have your child rest with their head and shoulders raised on pillows for the first day or so. This is to help ease swelling.
• Don't let your child rub the injured eye.
• Have your child rest or play quietly for 1 or 2 days. Make sure your child doesn't play roughly. Don't let your child play sports or run during this time.
• Follow the directions from your doctor on how to use an eye shield.

Follow up with your child's doctor or as advised.

Doctors are trained to see injuries such as this in young children as a sign of possible abuse. You may be asked questions about how your child was injured. Doctors must, by law, ask you these questions. This is done to protect your child.

Contact your child's doctor right away if any of the following occur:

• Vision problems, such as blurred vision
• Loss of vision
• Bleeding on the surface of the eye
• Bruising that spreads
• Swelling or pain that doesn't get better
• Nausea or vomiting
• Inability to move the eye
• Increased sensitivity to light

Call 911 if any of the following occur:

• Trouble breathing
• Rapid heart rate
• Symptoms of concussion (listed above)
• Seizure
• Stiff neck