The so-called black eye is caused by bleeding beneath the skin around the eye. Sometimes a black eye indicates a more extensive injury, even a skull fracture, particularly if the area around both eyes is bruised (raccoon eyes) or if there has been a head injury.
Although most black eye injuries aren’t serious, sometimes there is an accompanying injury to the eyeball itself sufficient to cause bleeding inside the eye. Bleeding in the front part of the eye, called a hyphema, is serious and can reduce vision and damage the cornea — the clear, protective “window” at the front of the eye. In some cases, abnormally high pressure inside the eyeball (glaucoma) can also occur. For this reason, it’s advisable to have an eye specialist examine your eyeball if there has been enough of an injury to cause a black eye.
To take care of a black eye:
Seek medical care immediately if you experience vision problems (double vision, blurring), severe pain, or bleeding in the eye or from the nose