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Black Eye

You think your black eye bugs you now? It's a good thing you didn't get your shiner back in the early 1900s! "Years ago people used to put a leech on a black eye to suck out the blood," says Jack Jeffers, M.D., an ophthalmologist at Wills Eye Hospital in Philadelphia, Pennsylvania.

Leeches got squashed as the treatment of choice once people found livestock more to their liking. "Sirloin steak is what my father used," says Jimmy, a second-generation butcher at Richard and Vinnie's Quality Meats in Brooklyn, New York. "When I was a kid, I used to get a lot of black eyes, and my father, being a butcher, used to put steaks on them. And it worked!"

Doctors no longer use leeches for treatment (thank goodness!), and it is unnecessary to waste a good steak on your eye. The best—and most effective—ways to block a black eye are much simpler than that. Here's how.

Pack it in ice. Jimmy's dad had the right idea, but it was the coldness of the steak, not the meat itself, that did the trick. In fact, a vegetarian would have gotten the same results by using iceberg lettuce!

Cold works in two ways. It helps keep the swelling down and, by constricting the blood vessels, helps decrease the internal bleeding, which is what causes the black-and-blue color.

Dr. Jeffers recommends applying an ice pack for the first 24 to 48 hours. "If your eye is swollen shut, use it for 10 minutes every 2 hours the first day," he advises. To make an ice pack for the eye, put crushed ice in a plastic bag and tape it to the forehead. This will prevent putting pressure on the eye.

Try the Tyson treatment. Champion boxer Mike Tyson has dished out lots of black eyes in his career. One of the fight doctors who has examined Tyson's battered opponents says that boxing trainers have a trick for treating black eyes that you can use outside the ring.

"Trainers use on the boxer's eye what looks like a small metal iron," says ophthalmologist Dave Smith, M.D., a member of the Medical Advisory Council of the State Athletic Control Board of the State of New Jersey, who has examined over 300 boxers for eye injuries. "It is extremely cold, and they use it to control the immediate hemorrhage so that the swelling is minimized. You can use the same sort of treatment by getting a cold soda can and holding it against the eye intermittently (5 to 10 minutes of every 15 minutes) until you can get some ice on it, says Dr. Smith. "Make sure the can is clean and then hold it lightly against your cheek, not your eye. Do not put any pressure on your eyeball."

Enjoy the show. Once the eye bruises, there's not a whole lot you can do except control the swelling. Even makeup can't disguise it totally. Most black eyes will last about a week, and it's a colorful week at that.

"The injury starts out black," says Keith Sivertson, M.D., director of the Department of Emergency Medicine at Johns Hopkins Hospital in Baltimore, Maryland. "Then as it starts to heal, it will turn green, then yellow, and finally it just disappears."

Avoid aspirin. Aspirin may be bad news for those with black eyes. Acetaminophen is what doctors recommend most. "Aspirin is an anticoagulant, meaning the blood won't clot as well. You'll have a harder time stopping the bleeding that causes the discoloration," says Dr. Jeffers. "You may wind up with a bigger bruise." If for some reason you need to take a pain reliever, take acetaminophen.

Don't blow your nose. If it was a severe blow that caused your black eye (something more than just bumping into a door), blowing your nose could cause your face to blow up like a balloon. "Sometimes the injury fractures the bone of the eye socket, and blowing your nose can force air out of your sinus adjacent to the socket," says Dr. Jeffers. "The air gets injected under your skin and makes the eyelids swell even more. It also can increase the chance of infection."

PANEL OF ADVISERS

Jack Jeffers, M.D., is an ophthalmologist and director of emergency services at the Sports Center for Vision at Wills Eye Hospital in Philadelphia, Pennsylvania.

Keith Sivertson, M.D., is director of the Department of Emergency Medicine at Johns Hopkins Hospital in Baltimore, Maryland.

Dave Smith, M.D., is an ophthalmologist in private practice in Ventnor City, New Jersey, and a member of the Medical Advisory Council of the State Athletic Control Board of the State of New Jersey. He is also on the medical team at the Sports Center for Vision at Wills Eye Hospital in Philadelphia, Pennsylvania.