How safe is a bruise in the eye?
If the eyeball turns blood red as a result of a bruise (hematoma), those affected usually initially fall out of all clouds. The bright red color is of course shocking at first, but is harmless in most cases. In many cases, only a ruptured blood vessel is responsible for the bruise in the eye , which can be easier than expected. A strong sneeze or cough and it’s done. Nonetheless, more serious health problems can occasionally be responsible for eye bleeding. The exact location of the bleeding and existing medical conditions are important.
Table of Contents
- How safe is a bruise in the eye?
- How does a bruise appear in the eye?
- Hyposphagma
- Bruise on the outer eye
- Bruising inside the eye
- Causes of bruising in the eye
- Harmless causes of bruising in the eye
- Eye hematoma due to heart and vascular diseases
- Bruising in the eye due to eye diseases
- Eye injuries and eye hematoma
- Concomitant symptoms
- diagnosis
- Eye test
- Tonometry
- Ophthalmic moduloscopy
- Smears and eye biopsies
- therapy
- Home remedies
- Naturopathy
- homeopathy
- nutrition
- Medication
- surgery
How does a bruise appear in the eye?
Our eyes ( oculus ) are traversed by a large number of blood vessels , which supply them with nutrients and oxygen. The larger blood vessels in this case run in the so-called choroid ( choroidal ), an essential portion of the central eye skin which extends between the sclera and the retina. A large part of the main and secondary branches of the ocular artery ( artery ophtalmica ) and the eye vein ( vena ophtalmica ) are located here, which serve as the main supplying vessels of the eye. In addition, there is a special layer of mucous membrane of the eye, namely the laterally located conjunctiva ( tunica conjuctiva), with smaller blood vessels called capillaries, which is why it also comes into question as the origin of bleeding.
A bruise in the eye looks terrifying, but is mostly harmless.
(Image: haoka / fotolia.com)
Hyposphagma
Strictly speaking, bleeding into the conjunctival tissue accounts for the largest percentage of all bruises in the eye. They are usually due to increased pressure in the capillaries, which burst as a result and can lead to blood leakage into the eye . Such bleeding is also known as hyposphagma. The term comes from ancient Greek and means something like “bloodshot eye”. Characteristic of Hyposphagmata are clear-cut sub bleeding of the eye, the space between the – dermis (- also called the white of the eye sclera be limited) and the conjunctiva. In this context, a medical distinction is made between two forms of the hyposphagma:
- Hyposphagma as a singular symptom
In this case, the bruise in the area of the conjunctiva occurs as a single symptom. There are no other accompanying symptoms – with the exception of a slight feeling of pressure resulting from the space-consuming spreading of the blood in the eye. This form of hyposphagma is usually due to harmless and harmless reasons such as a one-time, strong sneeze. - Hyposphagma as an accompanying symptom
Here, in addition to the bleeding into the conjunctiva and a possible feeling of pressure, there are also other accompanying symptoms of the hyposphagma, which usually indicates an existing underlying disease. For example, burning eyes, headache or limited vision are conceivable. If such accompanying symptoms occur, a visit to the doctor to clarify the health status is urgently required.
In the case of bruising in the eye, a distinction can also be made between external and internal bleeding.
Bruise on the outer eye
This bruise is usually one of the more harmless types of eye hematoma and is often caused by a hyposphagma. It is also conceivable that blood vessels in the eyelid ( blepharon ) are involved in the external bleeding, which is usually the case when subjected to external violence, such as a blow to the eye. Here the bruise arises under the skin of the eyelid and in a ring around the eye, which is why one speaks of a monocular hematoma. This eye hematoma is popularly known as the “black eye “.
Often a bruise in the eye is the result of a violent impact on the area of the eye, for example in the event of an accident. (Image: Bertold Werkmann / fotolia.com)
Depending on the intensity of the violent trauma, this hematoma can also cause swelling of the eyelids that is clearly visible from the outside, which is then mostly bluish to yellowish green. Since the blood always flows down due to gravity, sooner or later the blood in the case of a monocle hematoma mostly collects in the area of the lower eyelid. As long as no important structures of the eye have been damaged by the causal injury, the monocular hematoma is usually harmless. However, the situation is different with a bruise inside the eye.
Bruising inside the eye
A hematoma in the inner eye always occurs when deeper tissue layers have been damaged. A dangerous affair, because a serious injury to the eye, for example, from stab or cut injuries, is usually also accompanied by an injury to important elements of the eye structure that are essential for spatial vision, such as
- the visual lens (lens),
- the vitreous (corpus vitreum),
- the retina
- or the optic nerve (optic nerve).
Injuries to said structures can only heal to a limited extent or not at all. This in turn means that irreparable damage to the eye results from injury, which can result in permanent impairment of vision and, in the worst case, even complete vision loss. In addition, a particularly large hematoma can displace certain structures of the eye due to a strong blood flow and thus cause damage to important eye structures. If a bruise in the eye is particularly large or is accompanied by clear visual problems, those affected should urgently seek medical help to have the eye checked for its functions.
Causes of bruising in the eye
Basically, a bruise occurs in the eye whenever too much pressure is exerted on the blood vessels and they tear open as a result. The blood contained in the affected vessels then naturally pours freely into the eye, the size of the bruise depending on the size of the injured vessel or the extent of the injury.
Damage to the eye structure hardly heals by itself. (Image: Alexandr Mitiuc / fotolia.com)
Harmless causes of bruising in the eye
A bruise in the eye is relatively harmless if it comes from a short-term and one-time increase in intraocular pressure . This happens very easily with the capillary vessels of the conjunctiva. Broken vessels can occur in:
- a stay at high altitude (for example when climbing or flying),
- a stay at great depth (for example when diving or a cave hike),
- exceptional physical activity (e.g. heavy lifting),
- severe cough,
- strong sneezing
- or heavy pressing (for example, at birth or during bowel movements).
In addition, it is conceivable that certain medications lead to broken veins in the conjunctiva. Anticoagulants (for example ASA or heparin), which are intended to prevent blood clotting, increase the tendency of vessels to bleed because they thin the blood and thus promote the passage of blood fluid through the walls of the vessel.
Speaking of blood coagulation: As a special risk group, we should mention people who have an increased tendency to bleed. One speaks here of a so-called hemorrhagic diathesis. In addition to increased bleeding and bruising in the area of the gums, digestive tract, skin tissue and joints, these people can also experience vascular bleeding in the eye above average. In 70 percent of all cases, the symptoms are based on a disturbed synthesis of platelets, which manifests itself either in a lack of platelets, thrombopenia, or in thrombocytopathy, i.e. functional disorders of the platelets.
Rarely does hemorrhagic diathesis arise from coagulopathy and thus disorders in blood clotting itself or from diseases of the blood vessels . However, the latter play a major role as a separate cause of eye bleeding.
Changes in pressure at higher altitudes can cause bruising in the eye (Image: Visions-AD / fotolia.com)
Eye hematoma due to heart and vascular diseases
When it comes to diseases such as chronic high blood pressure , bruising in the eye is considered to be a disease-related accompanying symptom. Corresponding increases in blood pressure can also arise in the course of vascular-related metabolic disorders, which is particularly true for diabetes . Due to blood pressure, there is often a small amount of bleeding into the retina, which can even lead to impaired vision.
Hypertension is sometimes very often caused by hardening of the arteries (arteriosclerosis). Which is another important cause of bruising in the eye. The calcification of the arteries not only goes hand in hand with a higher pressure in the arterial vessels, but also gradually damages their vessel walls. In addition to the stressful pressure conditions in arteriosclerosis, the stability of the vessels is also enormously impaired. This can result in vascular damage and as a result of vascular bleeding that does not stop at the artery.
Thrombosis usually affects the eye vein. This leads to blood clots (thrombi) in the vessels, which sooner or later can also trigger a complete vascular occlusion. Medicine even knows an expression for such occlusions of the eye veins and calls a corresponding clinical picture central venous thrombosis. Due to increased pressure and possible vascular damage, it sometimes causes extremely dangerous bleeding in the back of the eye, which can affect both the retina and the optic nerve. Permanent visual damage cannot be ruled out in central vein thrombosis.
Damage to the retina can also cause bruising in the eye. (Image: sakurra / fotolia.com)
Bruising in the eye due to eye diseases
Of course, diseases of the eye are of particular concern for the eye and vision in eye hematomas. There are a variety of possible causes of bleeding here. In the first place, there should be extensive eye infections, such as
- Choroiditis( choroiditis ),
- Conjunctivitis( conjunctivitis ),
- Inflammation of the cornea( keratitis )
- or retinalinflammation ( retinitis ).
Above all , inflammation of the veins and retina are known to weaken the blood vessels of the eye in the advanced stage through corresponding inflammatory processes and thus cause vascular bleeding. The two diseases can also occur in combination in the form of chorioretinitis, which increases the risk of serious eye bleeding.
Attention: Inflammation of the retina and choroid carries an increased risk of permanent eye damage, which can lead to complete blindness due to retinal degeneration! An inflammation-related retinal detachment is often responsible for the loss of function.
Two other insidious eye diseases that can cause not only bruising inside the eye but also visual problems and complete vision loss are the glaucoma and cataracts. With glaucoma, there is a gradual loss of nerve fibers in the eye, which can also result in bleeding in the area of the affected nerves. In the case of cataracts, however, there is a clouding of the lens of the eye, the exact causes of which have not yet been fully clarified. In both cases, bruising and irreparable visual impairments are inevitable from a certain stage of the disease.
Eye injuries and eye hematoma
Eye hematomas can be similarly dangerous as with certain eye diseases if they are caused by injuries to the eye. The injury is often accompanied by a severe external force, which is the case with blows, falls and bruises, for example. Accordingly, you can
- physical disputes,
- Occupational accidents,
- Domestic accidents,
- Sports accidents
- and traffic accidents
with eye involvement always cause bleeding eye damage. Bruises on or in the eye are even more problematic if they are caused by cuts or stab wounds. A good example is poorly processed and therefore sharp-edged contact lenses. They can notch the cornea of the eye, which can also damage smaller blood vessels and even nerves. In addition, such injuries are very susceptible to infection, which in turn can trigger complicated eye infections.
A bruise in the eye can be a symptom of various eye diseases. (Image: Мар’ян Філь / fotolia.com)
An injury-related side effect during surgery is the eye hematoma in the course of the Lasik procedure. The surgical technique is used to correct ametropia. For this purpose, eye surgeons open the cornea using an eye laser and remove part of the horny layer in order to sharpen the angle of refraction of the eye. After the end of the operation, some patients experience a temporary bruise, since the laser processing naturally also penetrates blood vessels in the retina. However, the surgical wound is only a short-term side effect of the operation and usually resolves on its own after a few hours or days.
Concomitant symptoms
Concomitant complaints often determine whether the cause of a bruise in the eye is harmless or a health hazard. The following accompanying symptoms can occur in the context of an eye hematoma:
- bloodshot eyes,
- blood red spots,
- bluish green eyelid discoloration (black eye),
- Feeling of pressure in the eye,
- Flow of pus and secretions from the eyes,
- swollen eyelids,
- itchy or burning eyes,
- Foreign body sensation and sensation disorders in the eye,
- Headache,
- aching eyes,
- Dizziness,
- Visual disturbances
- and disease-specific complaints.
If the hematoma is harmless, apart from the red spots in the whites of the eyes caused by the bleeding and a slight feeling of pressure, which is attributable to the bleeding in the fluid, there are hardly any symptoms. In the case of a monocular hematoma caused by an eye bruise, swelling of the eyelids with bluish-green tissue discoloration can also occur. On the other hand, itching and burning, watery or festering eyes usually indicate an existing inflammation. Medical help is urgently needed here to prevent inflammation germs from spreading further in the eye and causing permanent eye damage.
The accompanying symptoms are even more extreme when there are deeper injuries to the vitreous body, the nerves and other eye structures that are important for the eyesight. Eye pain , headache , dizziness and visual disturbances are urgent signs that speak for a visit to the doctor.
Especially in the case of blood, heart and vascular diseases, patients should also pay attention to certain general symptoms. Fatigue, heavy weight loss, frequent urination and a persistent feeling of thirst can all indicate that you have diabetes. Thrombosis and hardening of the arteries (arteriosclerosis), on the other hand, usually become noticeable through high blood pressure , which can manifest itself, among other things, by a noticeably increased intraocular pressure . Central vein thromboses also rarely occur individually, but rather go hand in hand with thromboses and varicose veins on other parts of the body, for example the legs.
It is striking that the possible accompanying complaints depend very much on the underlying causes. Vision problems and intense sensation disorders are in any case a reason for a medical examination.
A slit lamp can be used to examine whether the eye structure is damaged. (Image: mmphoto / fotolia.com)
diagnosis
Of course, a bruise in the eye can first be determined on the basis of the optical changes. The red spot or the completely red discolored eye whites are the clearest sign of bleeding into the eye tissue. In addition, noticeable swelling and discoloration of the affected eyelid can be observed in the case of bruises. However, in order to determine the exact extent of any vascular and tissue injuries, a more detailed physical examination must be carried out medically. In addition to standard measures such as blood pressure measurements and blood tests to determine vascular health, there are several other options for this purpose:
Eye test
Within a vision test, various measures are used to examine whether there are certain visual complaints. The test can include visual acuity, contrast, or color vision tests. Depending on the area in which complications occur, experienced ophthalmologists can consider which structures of the eye have been injured.
Tonometry
Doctors use so-called tonometry to measure the intraocular pressure when high blood pressure is suspected , but also to uncover eye diseases such as glaucoma . A special examination device is used under local anesthetic of the cornea, at the end of which a measuring body is attached. This measuring body is carefully brought into contact with the cornea and then the pressure resistance of the eye is measured using sensors.
Ophthalmic moduloscopy
Illumination of the fundus by means of a slit lamp is also common. The incidence of light allows injuries and pathological changes to the eye to be determined that would otherwise remain hidden from the doctor’s eye-diagnostic assessment. Diseases of the retina in particular can be reliably identified in this way. In most cases, a pupil dilating medication is also administered to the patient to improve insight into the eye. The injection of contrast media also makes it possible to make unusual eye changes more visible.
Cataracts can be a symptom of bruising in the eye. (Image: zvitaliy79 / fotolia.com)
Smears and eye biopsies
In order to identify inflammation pathogens, doctors may also take a smear or a tissue sample from the eye if there is a specific suspicion. The samples are then examined in the laboratory to obtain more precise information about potential pathogens.
therapy
In addition to disease-specific treatment measures such as the administration of antibiotics for eye infections or laser surgery for diseases such as central venous thrombosis, there are also some measures that can be used to alleviate the bruise itself. Sooner or later, hematomas will clear up on their own, but it can help to support this healing process on your own initiative and thus relieve accompanying symptoms such as feeling of pressure and swelling. The patients have the following options to choose from.
Home remedies
As is well known, a black eye is best treated by targeted cooling of the affected eye area. For example, you can use cool packs, cooling compresses, ice cubes wrapped in a cloth or the famous frozen pack of peas. And cold treatment can also help with bruises inside the eye, since this causes the blood vessels to contract and further blood leakage is at least reduced.
Naturopathy
There are some medicinal herbs that promise good help for eye hematomas and bruises. These include in particular:
- Arnica,
- Eyebright,
- Comfrey,
- Oak bark,
- Fennel,
- Lady’s coat,
- John’s wort,
- Chamomile,
- Mullein,
- Linden flowers,
- Marigold,
- sage
- and cotton herb.
Arnica is one of many herbs that can support the healing process in the eye. (Image: David / fotolia.com)
You can either use the herbs for a soothing look at your eyes or simply use them as tea herbs. Eyebright in particular does not have its name for nothing, because the medicinal herb has been proven to work excellently for eye complaints of any kind.
Caution: If the eye is inflamed with moisture, no further moisture should get into the eye. Otherwise, the bacterial focus could spread further through the moist nutrient medium. In the case of eye infections, envelopes should be avoided!
homeopathy
The Homeopathy knows primarily globules from the aforementioned herbs. Arnica and comfrey globules are primarily prescribed for bruises in the eye. The Sumpfporst (Ledum) is also used homeopathically to treat eye hematomas.
nutrition
Even with the right nutrition, there is a lot that can be done to support the healing process in the case of bruises in the eye. Vitamin A is particularly important for strengthening the retina. The vitamin is also known as carotene because it is particularly abundant in carrots. But other vegetables and even some fruits contain carotene, including:
- Apricots,
- Broccoli,
- Lamb’s lettuce,
- Papaya,
- Paprika,
- Beetroot
- and spinach.
It is not by chance that these are often yellow or red foods. Because vitamin A is not only a nutrient, but also a colorant that gives yellow and red fruits and vegetables their color in many cases. In the eye, carotene also supports the visual purple ( rhodopsin ), which is responsible for the trouble-free function of the eye sticks in the retina. Visual discomfort that occurs in the course of an eye hematoma can possibly be alleviated in this way.
Carrots contain a lot of vitamin A, which strengthens the retina. (Image: atoss / fotolia.com)
Vitamins C and E are also important for the eye, more precisely for the removal of waste and pollutants from the eye. A well-functioning metabolism is also important in the case of an eye hematoma in order to accelerate the decrease in bleeding. In addition to paprika and broccoli , said vitamins can also be found in
- Kiwi fruit,
- Nuts,
- Parsley,
- Black currant,
- Bean sprouts,
- Asparagus,
- White cabbage
- and citrus.
Unsaturated fatty acids such as omega-3 and omega-6 fatty acids have a great influence on the nerve cells of the retina, as well as on the vascular health of the eyes. Their antioxidant effect keeps nerves and vessels fit and is also able to lower blood pressure and cholesterol levels, which prevents hardening of the arteries (arteriosclerosis). The foods that contain a particularly large number of unsaturated fatty acids include primarily fish and healthy vegetable oils such as
- Herring,
- Salmon,
- Linseed oil,
- Mackerel,
- Olive oil,
- Rapeseed oil,
- Tuna,
- Walnut oil
- and wheat germ oil.
Olive oil as well as salmon contain unsaturated fatty acids that help the eye to regenerate. (Image: karandaev / fotolia.com)
Medication
Medicinal products are particularly important for bruising the eye if there is an infectious eye infection. As long as the inflammation continues unchecked, the eye vessels cannot experience any improvement. Conjunctivitis in particular is highly contagious and requires prompt antibiotic treatment . The antibiotic active ingredients are then usually administered in the form of eye drops. Appropriate preparations are, for example, gentamycin, ciprofloxacin or ofloxacin. Alternatively, there are antibiotic eye ointments. Depending on the accompanying symptoms, pain relieving or decongestant drugs can also be administered.
surgery
If a bruise does not resolve itself, the last option to consider is surgical removal of the hematoma. For this purpose, however, the exact extent of the bruise must first be determined by means of ultrasound examination in order to know how far the area around the eye has been exposed to blood. During the operation, under local anesthesia, a small incision is made on the affected eye area and then the bruise underneath is emptied with special rinses. Then the cut is sealed. This process takes a total of about ten minutes to an hour.
