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2.01 Periorbital Ecchymosis (Black Eye)


Presentation

The patient has received blunt trauma to the eye, most often from a fist, a fall, or a car accident, and is alarmed because of the swelling and discoloration. Family or friends may be more concerned than the patient about the appearance of the eye. There may be an associated subconjunctival hemorrhage, but the remainder of the eye exam should be negative and there should be no palpable bony deformities, diplopia or subcutaneous emphysema.

What to do:

What not to do:

Discussion

Black eyes are most commonly nothing more than uncomplicated facial contusions. Patients become upset about them because they are so "near the eye," because they produce such noticeable facial disfigurement, and because there is often secondary gain being sought against the person who hit them. Nonetheless, serious injury must always be considered and ruled out prior to the patient's discharge from your care.

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from Buttaravoli & Stair: COMMON SIMPLE EMERGENCIES
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Craig Feied, MD
Mark Smith, MD
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