What Exactly Is a Black Eye?

A black eye, also known as a periorbital hematoma, is usually not an injury of the actual eye (which is why it is called “periorbital”- around the eye). It typically occurs when there is an injury to the face or the eye socket which causes bleeding beneath the skin and bruising. The term, “black eye” comes from the dark coloring of the bruising that occurs underneath the skin around the eye.

When a blunt force hits the eye socket, this can cause capillaries in the area to burst, causing hemorrhaging, also known as a hematoma. This blood can accumulate in the eye socket and as it begins to be reabsorbed into the surrounding tissues, the colors of the bruising begin to change. That’s why you will often notice the coloring of the black eye to go from a dark purplish-red color to brownish and then yellow.

Sometimes along with the external bruising, you might also notice a small amount of bleeding on the white surface of the eye, which is called a subconjunctival hemorrhage. This is when the tiny blood vessels on the white sclera are broken and leak blood. It’s generally harmless but sometimes looks scarier to the patient than the black eye does. This condition will also reabsorb on its own and is nothing to be concerned about.

While most black eyes can look pretty serious due to the dramatic color, an uncomplicated black eye will typically heal within a week to ten days. If it doesn’t, there could be a more serious issue such as a bone fracture or an orbital blowout fracture.This could present with restricted eye movement, especially if looking up or down, and numbness of the cheek and/or upper lip on the same side as the black eye. The eye may even appear sunken in. Further, if there is bleeding within the actual eye (called a hyphema) or floaters or flashes in the vision, then it is definitely advisable to see your eye doctor as soon as possible. These could be signs of more serious damage such a corneal or retinal damage and can lead to vision loss.

Treatment for a Black Eye

Usually, the best treatment for a black eye is to apply a cold compress (or even better, a bag of frozen vegetables, which is more flexible and can conform to the contours of the face) directly on the area. The cold will reduce swelling and constrict capillaries to reduce internal bleeding as well. Apply the cold for about 15-20 minutes every hour. If there is pain, over the counter pain medications can help.

If however, you experience any of the following symptoms, you should seek medical attention:

• Blood on the surface of the eye or a visible incision on the eye
• Vision changes such as double vision, blurred vision, loss of vision or the appearance of floaters
• Loss of consciousness, dizziness or fainting
• Loss of eye movement
• Persistent headaches
• Blood or fluids coming from the ears or nose
• Vomiting
• Signs of infection such as excessive swelling, pus, redness or a fever
• Severe pain

In addition to blunt trauma, black eyes can be caused by sinus infections, nasal or eye surgery or other infections in the area such as the teeth infections or cellulitis (a serious infection that can occur around the eyes). A skull fracture can also cause both eyes to turn black, sometimes known as raccoon eyes.

Unless you notice any severe symptoms you can rest assured that your black eye is a bruise just like anywhere else on the body and with a little care, rest and patience, it will clear up in no time.

Got a Shiner!

Jun 26, 2017

A black eye, also known as a periorbital hematoma, is usually not an injury of the actual eye (which is why it is called “periorbital”- around the eye). It typically occurs when there is an injury to the face or the eye socket which causes bleeding beneath the skin and bruising. The term, “black eye” comes from the dark coloring of the bruising that occurs underneath the skin around the eye.

When a blunt force hits the eye socket, this can cause capillaries in the area to burst, causing hemorrhaging, also known as a hematoma. This blood can accumulate in the eye socket and as it begins to be reabsorbed into the surrounding tissues, the colors of the bruising begin to change. That’s why you will often notice the coloring of the black eye to go from a dark purplish-red color to brownish and then yellow.

Sometimes along with the external bruising, you might also notice a small amount of bleeding on the white surface of the eye, which is called a subconjunctival hemorrhage. This is when the tiny blood vessels on the white sclera are broken and leak blood. It’s generally harmless but sometimes looks scarier to the patient than the black eye does. This condition will also reabsorb on its own and is nothing to be concerned about.

While most black eyes can look pretty serious due to the dramatic color, an uncomplicated black eye will typically heal within a week to ten days. If it doesn’t, there could be a more serious issue such as a bone fracture or an orbital blowout fracture.This could present with restricted eye movement, especially if looking up or down, and numbness of the cheek and/or upper lip on the same side as the black eye. The eye may even appear sunken in. Further, if there is bleeding within the actual eye (called a hyphema) or floaters or flashes in the vision, then it is definitely advisable to see your eye doctor as soon as possible. These could be signs of more serious damage such a corneal or retinal damage and can lead to vision loss.

Treatment for a Black Eye

Usually, the best treatment for a black eye is to apply a cold compress (or even better, a bag of frozen vegetables, which is more flexible and can conform to the contours of the face) directly on the area. The cold will reduce swelling and constrict capillaries to reduce internal bleeding as well. Apply the cold for about 15-20 minutes every hour. If there is pain, over the counter pain medications can help.

If however, you experience any of the following symptoms, you should seek medical attention:

– Blood on the surface of the eye or a visible incision on the eye
– Vision changes such as double vision, blurred vision, loss of vision or the appearance of floaters
– Loss of consciousness, dizziness or fainting
– Loss of eye movement
– Persistent headaches
– Blood or fluids coming from the ears or nose
– Vomiting
– Signs of infection such as excessive swelling, pus, redness or a fever
– Severe pain

In addition to blunt trauma, black eyes can be caused by sinus infections, nasal or eye surgery or other infections in the area such as the teeth infections or cellulitis (a serious infection that can occur around the eyes). A skull fracture can also cause both eyes to turn black, sometimes known as raccoon eyes.

Unless you notice any severe symptoms you can rest assured that your black eye is a bruise just like anywhere else on the body and with a little care, rest and patience, it will clear up in no time.

This year, make healthy eyes and vision your resolution. Find out if you or a loved one is at risk for glaucoma, and take steps for prevention.

Glaucoma is a leading cause of preventable vision loss and blindness in adults in the United States and Canada and the second leading cause of blindness in the World. Projections show that the number of people with the disease will increase by 58% by 2030. These facts however could change with proper awareness.

When detected in the early stages, glaucoma can often be controlled, preventing severe vision loss and blindness. However, symptoms of noticeable vision loss often only occur once the disease has progressed. This is why glaucoma is called “the sneak thief of sight”. Unfortunately, once vision is lost from the disease, it usually can’t be restored.

Risk Factors

Prevention is possible only with early detection and treatment. Since symptoms are often absent regular eye exams which include a glaucoma screening are essential, particularly for individuals at risk for the disease. While anyone can get glaucoma, the following traits put you at a higher risk:

• Age over 60
• Hispanic or Latino descent, Asian descent
• African Americans over the age of 40 (glaucoma is the leading cause of blindness in African Americans, 6-8 times more common than in Caucasians.)
• Family history of glaucoma
• Diabetics
• People with severe nearsightedness
• Certain medications (e.g. steroids)
• Significant eye injury (even if it occurred in childhood)

What is Glaucoma?

Glaucoma is actually a group of eye diseases that cause damage to the optic nerve due to an increase in pressure inside the eye or intraocular pressure (IOP). Treatments include medication or surgery that can regulate IOP and slow down the progression of the disease to prevent further vision loss if detected early. The type of treatment depends on the type and the cause of the glaucoma.

What are the Symptoms?

Most times glaucoma does not have symptoms. There is no pain unless there is a certain type of glaucoma called angle closure glaucoma. In this case, the channel of outflow gets crowded then blocked, causing foggy, blurred vision, halos around lights, headache and even nausea. This is a medical emergency and should be assessed immediately as the intraocular pressure can become extremely high and cause permanent damage within hours.

Most forms of glaucoma have an “open angle”, which is not so urgent, but does need compliance with the treatment plan (which is sometimes difficult as some of the glaucoma drops have uncomfortable side effects). Once vision loss develops it typically begins with a loss of peripheral or side vision and then progresses inward.

What Can You Do To Prevent Glaucoma?

Because there are no symptoms, regular eye exams are vital to early detection. If you have any of the above risk factors or you are over 60, make a yearly comprehensive eye exam part of your routine. Make sure that your eye doctor knows your family history and any risk factors that are present.

A comprehensive eye exam can determine your risk of developing glaucoma; if you have been diagnosed with glaucoma and have concerns about your treatment, it is best to speak openly with your doctor. Remember, a simple eye doctor’s appointment on a regular basis could save your vision for a lifetime.

The most well-known part of a comprehensive eye exam is the basic vision test. When you have a general vision test, one of the main conditions the eye care practitioner is checking for is a refractive error. A refractive error means there is an abnormality in the shape of the eye, changing the eye’s ability to focus light directly onto the retina.This causes blurred vision and can usually be corrected by wearing prescription eyeglasses, contact lenses and possibly, alternate treatments such as vision therapy, ortho-k, LASIK or refractive surgery such as LASIK.

The term, “refractive error” refers to a problem with the process of refraction that is responsible for sight. Normally, light rays that enter your eye are refracted or bent through the cornea and the lens, and ultimately converge or are focused onto a single point on the retina. From the retina, messages are sent through the optic nerve to the brain which then interprets these signals into the image that we are seeing.   

In order for this process to work effectively, the anatomy of the eye including the length of the eye and the curvature of the cornea and the lens must be just right to be able to focus the light onto the retina. When this is not the case, a refractive error will occur.

There are several different types of refractive errors, depending on which part of the eye is affected, and it is possible to have multiple refractive errors at the same time:  

Myopia or nearsightedness:

In myopia the length of the eyeball is too long which results in light coming to a focus in front of the retina, rather than on the retina. This allows the individual to see well when objects are close but not clearly when looking at objects at a distance.

Hyperopia or farsightedness:

Hyperopia is when the eyeball is shorter than normal and can result in near objects being blurry. However, people experience hyperopia differently. Sometimes distant objects are clear while other times people may experience overall blurred vision near and far or no problems at all. In children particularly, the lens may accommodate for the error allowing for clear vision but may cause fatigue and sometimes crossed eyes or strabismus. Hyperopia causes eyestrain or fatigue especially when looking at near objects for a period of time. Often people with 20/20 vision may still need glasses at their desk to relax their eyes and improve concentration.

Astigmatism:

Astigmatism is usually the result of an irregularly shaped cornea (although it can sometimes also be due to a misshapen lens). The cornea, which is normally round, is more football-shaped in an eye with astigmatism, resulting in multiple focus points either in front of the retina or behind it (or both). People with astigmatism usually have blurred or distorted vision to some degree at all distances, near and far.

Presbyopia:

Presbyopia is an age-related condition which usually begins to appear sometime after 40.  As the eye begins to age, the lens stiffens and can no longer focus clearly on objects that are close.  

It’s important to note that presbyopia is often confused with hyperopia, as both cause problems focusing at near distances.  However, high hyperopia can also cause blur at far distances as well, especially in dim lighting, and depth perception problems can result in motor vehicle accidents.  In these instances people with hyperopia could use glasses at any distance.

If you are having trouble seeing, it is important to have an eye exam to determine the cause of the problem and to effectively correct your vision. Even if your vision is fine, you should schedule a routine eye exam on a regular basis to ensure that your eyes are healthy and that any potential problems are caught early.

‘Tis the season for giving, and parents, grandparents, family and friends need to know which toys and games to leave off the list because they can pose a risk to children’s health and eyesight. Last year nearly 252,000 emergency visits were due to toy-related injuries, almost half of which were to the head or face. Further, about 1 in 10 children’s eye injuries treated in the emergency room can be traced back to toys, most of which occur in children under 15 years of age.

The most common types of eye injuries that occur from toys can be anything from a scratch on the cornea (the front surface of the eye) to very serious injuries that can threaten vision such as traumatic cataracts, corneal ulcers, bleeding inside the eye and retinal detachment.

Most of these injuries can be prevented by taking the proper measures to evaluate the safety of gifts before they are purchased and to supervise children during any play with toys that could have the potential to cause damage or harm.

Here are some tips on how to select safe toys for children this holiday season:

1. Check age recommendations on all toys to make sure they are age appropriate and suitable for the child’s maturity level. If younger siblings are present, ensure that any toys made for older children are kept out of reach.
2. When possible, check toys for a seal of approval that the product meets national safety standards from a toy safety testing organization such as the American Society for Testing and Materials (ASTM) or the Canadian Toy Testing Council.
3. Do not purchase toys that have a projectile or sharp, protruding parts. Toys such as darts, guns, arrows or sharp propelling toys can cause serious eye injuries that can lead to permanent eye damage and even vision loss. Even high-powered water guns such as super soakers or soft foam dart guns can cause significant damage when shot at close range.
4. Purchase safety eyewear with polycarbonate lenses to accompany sports equipment, chemistry sets or woodworking tools. Speak to your optometrist to learn more about the best option for your child’s hobby of choice.
5. Check that toys with sticks or handles such as swords, fishing rods, pogo sticks, brooms or pony sticks have rounded edges or handles and avoid or supervise use with little children.
6. Any toys or devices that have a laser or bright light (such as laser pointers or flashlights which are sometimes used by kids to play laser tag) can be dangerous. Bright lights such as those produced by high-powered flashlights can cause temporary vision loss that can lead to a risk of a fall or accident. Further, laser pointers are not safe for use by children as the light intensity can cause permanent vision loss if shined in someone’s eyes.

When purchasing a toy for a child that is important to you, make sure you are considering what is most important – their safety. Ask us if you have any questions about the eye safety of a toy or gift you are considering.

Have you ever thought about how vision works? Seeing is an incredible gift made possible by a system in which the eye and the brain process visual information from the outside world. If any step of that process does not function properly, vision will be impaired.

Similar to a camera, the eye transmits light from the world around us into an image that we can perceive. Certain parts of the eye even function like the different parts of a camera such as the shutter, the lens and film (if we can hearken back to the days when we used film in cameras). Here is a quick breakdown of the fascinating way our eyes and brain enable us to see and experience the world around us:

The Vision Process

Light reflected from an object in our field of view is gathered by the cornea which is essentially the clear “window” to our eye. The cornea then refracts the light rays through the pupil (the center of the iris where light enters the eye). The iris, which like the shutter of a camera will enlarge and shrink based on how much light is coming in, then passes the image onto the crystalline lens. Just like a camera lens, the lens in the eye focuses the light rays, projecting them to a point at the back of the eye called the retina, where the image will appear upside down. The retina contains a thin layer of color-sensitive cells called rods and cones that perceive color.

From the retina, the visual signals travel to the brain via the optic nerve. The brain receives information from both eyes and must then converge the images (and flip them right side up) to get a complete picture.

Vision Problems

A breakdown in vision can happen at any point in this process. From the muscles that control the eyes, to the parts within the eye, to the pathway to the brain. Sometimes vision impairment is due to technical problems with the eye receiving the information and passing the signal on, such as convergence insufficiency (inability to coordinate the eyes to converge on one point), myopia (nearsightedness) or cataracts (clouding of the lens).

Other times, the eyes might work perfectly, but there is a problem with the brain interpreting the signals it receives. In these cases we can’t “see” in the traditional sense, because our brains aren’t able to properly “read’ the signals or we don’t know what we are looking at. This is the case for some learning disorders that are caused by the visual processes in the brain such as dyslexia.

As you can see, vision is quite a complicated process. A simple vision exam isn’t always able to determine vision problems, especially in children which is why it is so important to have regular comprehensive eye exams, to measure the health of the eye and all of its parts.

Eye Complications of Diabetes

It's true. Diabetics have a higher risk of blindness than those without the disease. That fact coupled with the superior prognosis of early intervention, makes it easy to understand why eye care professionals and other doctors say routine eye care is absolutely essential. Below, we'll discuss what your eye doctor is looking for during a diabetic eye exam.  

As the incidence of diabetes increases, it is important to spread awareness about the risks and proper preventative care for diabetes patients. November is Diabetes Awareness month, so read on!

Diabetics are at greater risk for a number of eye problems.  

Diabetic Retinopathy:

Diabetic retinopathy is the term used for the disorders associated with diabetes that cause progressive damage to the retina.  The longer a patient has had diabetes, the more likely it is that he or she will develop these conditions which can be very serious, vision-threatening complications. 

There are two types of retinopathy: nonproliferative and proliferative. 

Nonproliferative retinopathy, which is the most common form, is when capillaries at the back of the eye become weakened and may start to leak blood and fluids. Nonproliferative retinopathy, which often has no symptoms, can be characterized as mild, moderate or severe, depending on how many blood vessels are affected and becoming blocked. This type of retinopathy usually doesn't require treatment and doesn't cause vision loss, unless the leaking fluid ends up in the macula where the eye focuses – a condition called macular edema. If this happens, vision can be blurred and even lost so preventative treatment is essential.  

Proliferative retinopathy is much more severe. This is when so much damage is done to the blood vessels that they begin to close off. New blood vessels begin to grow in the retina as a response to this deterioration. The new and weak vessels can leak blood, impairing vision, or can form scar tissue which can distort the retina or cause a retinal detachment.

Proliferative retinopathy requires urgent referral to a retinal specialist for treatment. While it usually takes years to develop, some instances of proliferative retinopathy can occur within weeks or months if blood sugars are not well-controlled. Pregnancy can also accelerate proliferative retinopathy in known diabetics. Yet if detected early, treatment can be done successfully. 

Like high blood pressure, there are often no warning symptoms until advanced stages of diabetes. It is best to get checked each year by your eye doctor. If you experience any changes in your vision such as spots in vision, flashes of light, blurred or double vision (rarely pain), make an appointment with your eye care professional immediately. Treatments do exist for retinopathy and many of them are successful in repairing damage and sometimes even restoring vision.

Cataracts: 

Cataracts are a clouding of the lens of the eye which blocks light from entering and impairs vision. While cataracts are a fairly common and treatable condition, people with diabetes are 60% more likely to develop the condition and often get them at a younger age. Those with the condition also may experience vision fluctuation which occurs from sugar levels affecting the lens of the eye. Cataracts often progress faster in diabetics as well. In serious cases of cataracts, a surgical procedure is done to remove the natural lens of the eye which can sometimes cause complications in diabetic patients that may already have symptoms of other conditions such as diabetic retinopathy.

Glaucoma:

Glaucoma is a serious condition where pressure builds up in the eye causing damage to the retina and optic nerve and eventually if left untreated, blindness.  Diabetics are 40% more likely to develop glaucoma and the risk increases with age and the amount of time the individual has had diabetes. There are treatments for glaucoma including medications and surgery but early detection and treatment are essential to prevent permanent vision loss. Glaucoma is often called the "silent thief of sight" because vision loss often doesn't occur until significant damage is done. Therefore, yearly eye exams are essential. 

Cornea Alterations:

Diabetics may experience reduced sensitivity in their cornea. This means that contact lens wearers that are diabetics should be more cautious, as they develop higher tolerance if the lens irritates the eyes and may be at greater risk of infection. 

Eye Muscle Disturbance:

More advanced diabetes cases can show restriction of eye muscle movement due to nerve palsy. 

For diabetics, the key to early detection and treatment – and therefore preserving your vision – is to have your eye health monitored on a regular basis. Get your eyes examined every year by an eye care professional and if you experience any changes in your vision such as spots, floaters, blurred vision or pain, make an appointment with your eye doctor immediately. 

Beware this Halloween and think before you blink (in decorative contact lenses that is)! Sure, decorative contact lenses can enhance any Halloween costume, but if not taken seriously, they can also cost you your vision. Whether they are sold as cosmetic lenses, colored lenses or fashion lenses, they are anything but cosmetics – they are medical devices that must be approved by the FDA and properly fit and handled. Stores selling decorative lenses without requiring a prescription are breaking the law.

All contact lenses must be properly fitted by an eye doctor that has measured your eye and given you proper handling and care instructions.  A poor fit can result in serious eye damage, corneal scratches, infections, vision loss and even blindness. 

When purchased and handled properly, decorative lenses can be a fun (or spooky) addition to your costume, so go ahead and purchase them, but do it safely. 

Here is the right way to buy decorative lenses:

• Get a contact lens eye exam and fitting from a licensed eye doctor and a valid prescription for contact lenses that includes the lens measurements, brand, base curve, diameter, power and color as well as an examination date and an expiration date. When the lens is coming from a legitimate source, the lens supplier ensures it has not expired and that manufacturer takes care of the material and tracking bar codes. 
• Optimally, have your eye care professional order the lenses or if that is not possible, purchase lenses from a registered store or online shop that requires you to provide this prescription to ensure that it is properly fit.
• Follow the directions for cleaning, storing and wearing lenses.
• See your eye doctor immediately if you experience persistent redness, pain or vision disturbances.
• Important note: Many patients believe that a routine eye exam and eye glasses prescription is the same as a contact lens prescription but this is not the case! Many online companies do not advise people of the difference or do not adhere to the one year prescription expiration. This is a big concern for eye doctors because eye health changes can detrimentally affect contact lens wear. All contact lenses should be checked yearly by an eye doctor or registered contact lens fitter. 

Contact us today to book a contact lens exam.