Causes of bruising in the eye
The most common cause of hematomas inside and outside the eye is trauma. As a rule, it is blows or blunt injuries in an accident that accelerate the eye in its position in such an unphysiological way that the smallest blood vessels rupture and bleeding occurs. A bleeding under the conjunctiva, a so-called hyposphagma, can result from burst veins.
This can be exacerbated by the use of so-called blood thinners (e.g. ASS). A cough or sneeze can easily cause bleeding in the eye. The cause is usually an increased blood pressure, which causes this type of haematoma in the eye.
This can look frightening, but is usually harmless and painless. Blood coagulation disorders, which can also occur in the context of an alcoholic illness, can also cause the veins in the eye to burst. This is called hyphaemia in technical jargon.
This can disrupt the flow of water and lead to increased intraocular pressure. The blow to the unprotected eye is the most common cause of bruising outside and inside the eye. Depending on the force acting on the eye and the position of the eye at that time, the most severe structural injuries in the eye can occur in addition to a haematoma in the eye.
These can also partially endanger vision. Tears of the lens and ciliary muscles, optic nerve or vitreous body injuries with accompanying bleeding make a particularly cautious approach to diagnosis necessary. Usually the first symptoms after a blow to the unprotected eye are initially passagere blindness, which recedes within a few seconds or minutes, and a flash in the eye (this is the link to causes of blindness).
The most important measure after a violent impact on the eye is to clarify the extent of the injuries. Ultrasound or even MRT examinations are used here. It may be necessary to surgically remove a hematoma caused by a blow to the eye.
If no structures are endangered, a wait-and-see approach can be chosen. The edges of contact lenses can lead to injuries in the eye, cause the veins to burst and produce a bruise in the eye. If pain and visual disturbances occur at the same time, a doctor should be consulted.
Furthermore, the cornea of the eye can be abraded by clumsy handling of the contact lenses. This is also known as erosion of the cornea. The affected person usually has severe pain, since not only blood vessels but also corneal nerves are affected.
In addition, strong tears, eyelid cramps and reddening of the eyes occur. The corneal abrasion is often not visible to the naked eye. If this is not noticed and treated, a corneal infection can develop.
If a vein has already burst for other reasons, wearing contact lenses can sometimes increase the bruising in the eye. If the edge of the contact lens presses on the injured blood vessel, this can lead to renewed or further damage. Therefore, it is recommended to use glasses instead of contact lenses as a visual aid until the bruise in the eye has subsided.
If the combined solution causes a burning sensation when the contact lens is inserted, a doctor should be consulted. In the case of existing wounds and injuries, contact lenses can cause secondary bruising of the eye. Lasik surgery is a surgical procedure that can be used to treat defective vision within a few minutes by means of laser treatment.
In this procedure, the laser is used to open up part of the cornea and remove the corneal structure, which then changes the refractive power of the eye. Sometimes a small haematoma can occur inside the eye shortly after the operation. Patients usually notice this bruise due to impaired vision (for example a dark spot when fixing a point).
As a rule, the bruise recedes within a few hours or days and no longer causes any discomfort. Especially the external bruise of the eye does not usually need to be treated. One reason for this is that the space outside the eye is more generous than inside the eye.
The blood can expand without displacing or injuring important structures of the eye. On the other hand, the haematoma is often reduced by itself and does not require any further treatment. In some cases, however, the haematoma may have caused so much blood to be distributed around the eye that the pressure on the eyeball is increased.
This is dangerous, as it can lead to damage to the optic nerve. Bruises that do not break down and lie outside the eye must be surgically removed. This measure is rarely used, but is sometimes necessary.
For this purpose, the spread of the haematoma is first determined by an ultrasound examination in a clinic for ophthalmology. Then a small incision is made at the site where the most blood has accumulated and the effusion is removed by irrigation. The skin is then closed again.
The procedure takes place under local anaesthetic and lasts from about ten minutes to an hour, depending on the extent of the bruise. Bruises that occur inside the eye must first be visualized by imaging to determine the amount of blood and how it spreads. Before any treatment, it is particularly important to find out how large the haematoma is and which structures in the eye it is likely to compress or constrict.
Ultrasound and MRT are used for this purpose. If no important structures are constricted by the haematoma and thus the visual process is not endangered, it is possible to wait for the time being. In many cases, the bruise also reduces itself within the eye.
However, it is important to check the size and spread of the effusion from time to time. If a bruise increases in size and circumference or if important structures such as the lens, vitreous body, retina or even the optic nerve are at risk, a minimal surgical removal operation must be performed. In a clinic for ophthalmology, such small incisions are made next to the eyeball to create an access to the eye.
Then the hematoma is slowly suctioned out with the smallest instruments. Depending on its location and size, the operation can take up to two hours. It is important to proceed very gently in order not to endanger important structures in the area of the eye.
If there is a harmless bruise in the eye, no treatment is necessary. However, some patients find an accompanying homeopathic treatment supportive. The treatment should be guided by a specialist.
A homeopathic treatment does not replace conventional medical therapy. Arnica can have a soothing effect, especially in the case of bruising of the eye, which is accompanied by pain and swelling, but also in the case of harmless bruising of the eye. Adults are recommended to take 5 globules in potency C5 every 15 minutes in the first hour after the event causing the bruising, and then 5 globules every hour.
For children, arnica in potency C9 may be advisable. In case of eyeball contusions, which are accompanied by dull pain and problems opening the eyes or after bleeding in the eye or eyelids, Ledum can in some cases support the healing process. In this case, 3 globules in the corresponding individually agreed potency are usually recommended 3 times a day. If Arnica and Ledum do not provide any relief, Symphytum may also support the healing process of more recent injuries in and around the eye.