Black Eye in Children: Causes, Symptoms, and First Aid Care

A black eye (periorbital bruising) commonly occurs when a child is struck near the eye or bumps into a hard surface. While many black eyes are minor and heal on their own, it is important to monitor children closely, as injuries around the eye can sometimes indicate a more serious issue.

In Canada, black eyes are frequently seen after sports injuries, playground falls, household accidents, or being hit by a ball or object. Even when the injury appears mild, proper first aid and observation are essential.

What Causes a Black Eye?

The most common cause is a direct blow to the eye or nose. This impact damages small blood vessels in the soft tissues around the eye, causing blood to leak under the skin. The result is swelling and bruising.

Because the skin around the eye is thin and delicate, bruising can look dramatic even when the injury itself is not severe.

Signs and Symptoms of a Black Eye

A child with a black eye may experience:

• Pain or tenderness around the eye

• Swelling of the eyelid or surrounding area

• Bruising that changes colour over time (red → purple → green/yellow → dark)

The appearance may worsen over the first 24 hours before gradually improving.

When to Seek Medical Care

A child should be assessed by a healthcare professional immediately if any of the following are present:

• Blurred or double vision

• Difficulty seeing or moving the eye

• Inability to move the eye in all directions

• Redness or swelling in the white part of the eye

• Both eyes are bruised, especially after a head injury

• Cuts near the eye or suspicion of eye penetration

Additional warning signs that require medical attention include:

• Headache, nausea, or vomiting

• Drainage of blood or clear fluid from the nose or ears

• Drowsiness, confusion, or unusual behaviour

These symptoms may indicate a head injury or eye trauma, not just a simple bruise.

First Aid Management for a Black Eye

For uncomplicated black eyes:

• Apply a cold pack or wrapped ice to the affected area for 10–20 minutes every 1–2 hours during the first 24 hours

• Ensure the ice is wrapped in cloth—never place it directly on the skin

• Keep the child’s head elevated, including during sleep, to reduce swelling

Bruising and swelling usually improve within 1–2 weeks.

This information is intended to support early first aid response, but it does not replace medical evaluation. Eye injuries should always be taken seriously, particularly in children.

Why First Aid Training Matters

Knowing how to assess facial injuries, recognize red flags, and provide immediate care can prevent complications and reduce anxiety for parents and caregivers. Pediatric injury response, bleeding control, and head injury awareness are key components of first aid education in Canada.