Been in a fight? Here's some information about black eyes and possible cures you might try. This should be especially helpful for fans of Fight Club...

What is a black eye?

A black eye, sometimes called a shiner, is bruising around the eye, caused by impact to the eye area, nose or brow eg from a fist or a ball or as a result of a fall. It may also occur after facial surgery. As with any other bruise, initially it appears reddish due to blood from broken capillaries pooling under the skin. The tissues are likely to swell, causing the eye to close and the area will be tender. Over the next few days as the haemoglobin in the blood breaks down and the blood is gradually absorbed into surrounding tissues, the colour changes to dark purple-black then through shades of yellow and green to muddy brown and eventually fades away.

Is it serious?

Normally a black eye looks impressive but is not a serious injury. However, there may be associated eye injury such as a retinal detachment, bleeding in the eye or an orbital fracture. Emergency attention is required if the injury involved loss of consciousness, if both eyes are affected, the eye itself appears damaged, if there is double vision, loss of vision (other than because the eye is closed) or if an accompanying headache is severe. Symptoms that develop such as sudden floaters, pain with eye movement, change in vision should be investigated. If in any doubt, seek medical advice.

Is there any treatment?

A black eye will usually subside without any treatment, within two weeks, but there are some self-help measures to alleviate symptoms.

An ice pack

This needs to be applied as soon as possible after the injury. The chill should constrict the blood vessels, therefore slowing the rate of blood flow, which will minimise the amount of swelling. It will also numb any pain. Wrap loose ice, a gel ice pack or a pack of frozen peas, for example, in a tea towel. Hold the ice pack gently against the bruised skin for about 20 minutes. Repeat once an hour for the rest of the day.

Washing

Gentle cleansing with mild soap and warm water will remove any dirt so as to avoid infection. Thereafter try to keep the area clean and dry.

Elevation

Keeping the head elevated and slightly tilted back will help reduce the amount of swelling and blood pooling. Extra pillows will be useful when sleeping; plenty of rest will help, avoiding sleeping on the affected side.

Warm compress

As the bruise starts to appear, a warm facecloth, a wheat bag or rice in a clean cotton sock heated in a microwave, gently held against the area will help promote circulation and absorption of the blood. Check that the compress is not too hot and only use for up to 20 minutes at a time.

Medicines

Mild anti-inflammatory analgesics such as paracetamol or ibuprofen may be used to relieve pain and swelling. Do not use aspirin as this is has anticoagulant properties.

Unofficial alternative remedies

There are a number of suggested therapies which are not medically proven to be safe and effective and therefore only included here for interest, not as recommendations. Care must be taken to avoid any contact with the surface of the eye as this may cause severe irritation, damage or infection.

Hardboiled Egg

Either use a whole hardboiled egg, or some like to substitute the yolk for a silver ring, in which case wrap the egg white and ring in a clean cloth. While the egg is still warm, roll it over the affected area. The theory behind this is that the silver ring and the egg are supposed to draw out toxins from the bruised skin. More likely it is a similar effect to a warm compress. The addition of a silver ring is of dubious benefit. However, the effect of any placebo in natural healing should not be overlooked.

Arnica

Arnica, in gel or cream form is a popular natural remedy for bruising. It is supposed to stimulate white blood cells to fight infection and eliminate foreign substances. Do not use on broken skin.

Herbal remedies

There are a number of plants and foodstuffs regarded as having anti-inflammatory or analgesic properties when the appropriate parts are used in a paste or infusion soaked cloth. These include witch hazel, potato, yarrow, dandelion, oatmeal. Note that these should not be allowed to come into contact with the eye itself.

A cold tea bag, slices of cucumber, onion poultice, butter and salt have all been suggested as helpful remedies.

A mixture of 1 part cayenne pepper to 5 parts Vaseline is also suggested to be applied to the skin and left for a few hours. The theory for this is unknown, but the Vaseline may be soothing to the skin which will engender a feeling of wellbeing.

Diet

There are suggestions that eating a diet rich in vitamin C and antioxidants will aid healing. Whilst there is no firm evidence for this, at least it constitutes part of a healthy diet in general. Suggested foodstuffs include garlic, fresh fruit and vegetables.

Commercially available preparations

There are a number of tablets and creams containing Vitamin C, E or K or various plant substances, all of which are supposed to aid healing. Whilst lack of some of these may predispose one to bruising, it is unlikely that sudden consumption or application will have much effect on an existing bruise. Always read the instructions carefully.

Leeches

Historically, leeches were used on a black eye, to consume the pooled blood. Leeches have come back into medical favour as an aid to promote wound healing eg a reattached finger, by promoting blood flow through the affected part.

What NOT to do

There are some things you should definitely avoid.

Raw Meat

Offering a piece of raw steak to put on a black eye is common practice in dramatic fiction. This is definitely a bad idea, because raw meat contains bacteria which could cause infection.

Nose blowing

If the eye socket is fractured, nose blowing can force air from the sinuses out and under the skin causing extreme swelling and possibly infection too. Sniff gently or wipe your nose instead.

Prevention is better than cure

Easier said than done, but thinking ahead and taking preventative action may save your eyes from injury. Wear suitable eye protection and use appropriate safety equipment when embarking on any activities involving potentially moving objects, eg DIY, sport, driving. Be careful of loose rugs or items in the home that could be a trip hazard. Ensure that there is adequate lighting on stairs. Avoid excess alcohol as this is frequently a precursor to street fighting. Learn strategies to take the heat out of arguments or difficult situations. Learn some self-defence techniques. If confronted by an unreasonable aggressor try to stay out of arm's reach and make sure you have an exit behind you.

And finally

If all else fails, don some dark, UV absorbing sunglasses, think up a good story to explain your black eye and be patient while it heals.