Ophthalmology

Ophthalmic hematoma

Introduction - What is an eyeglass hematoma?

A glasses hematoma is a bleeding in the skin that spreads around the eye socket and thus discolors both the lower and upper lungs. As a result of the bleeding, the skin gets a different color at this point, which can vary from black / blue to brown / yellow, depending on how old the hematoma is.

The eyeglass hematoma occurs on both sides and, as the name suggests, resembles glasses in its shape. If such a hematoma is only present on one side, it is called a monocular hematoma. The most common cause of a glasses hematoma is a fracture of the base of the skull caused by an external force.

Find out more about the topic: Black eye - what to do?

Detecting a hematoma of glasses

What are the symptoms of eyeglass hematoma?

A glasses hematoma is always accompanied by discoloration of the affected skin area. Depending on the age of the hematoma, the color can vary from black to blue to yellow. In addition, the area around the eye is swollen with a spectacle hematoma. The leaked blood, which is only gradually broken down, creates a pressure-sensitive swelling. Depending on the size of the swelling, it is possible that the eye can no longer be opened properly. Another accompanying symptom can be a feeling of pressure and numbness in the affected body region. The pain that occurs with a glasses hematoma is also worth mentioning.

Find out more about the topic: Pain in the eye socket - What is behind it?

Does a spectacle hematoma cause pain?

If you have a hematoma from glasses, a lot of blood has flowed into the tissue around your eye. Most of the time, the hematoma of the glasses is based on a great deal of force and thus also a severe vascular injury, and the accompanying pain is correspondingly high. The region is particularly sensitive to pain under pressure. The leaked blood automatically creates pressure on the surrounding tissue, including the nerves and pain receptors, which causes the pain. As the swelling subsides, the pain also subsides.

Is there any swelling with a glasses hematoma?

Swelling is one of the symptoms of a glasses hematoma. Because blood enters the tissue through a vascular injury, it swells.The blood is only gradually broken down by the body, and the swelling lasts just as long. The pressure exerted on the tissue by the blood also creates pain and tenderness. The swelling can mean that the affected person cannot or can barely open his eyes. Correspondingly, in severe cases, the field of vision can be reduced until the swelling subsides again.

Find out more about the topic here: Puffy eyelids

How is an eyeglass hematoma diagnosed?

In the case of a glasses hematoma, the doctor will first ask the patient about an accident or fall to make a diagnosis. This is used to research the cause and to rule out diseases that can cause hematomas. The patient is allowed to tell the doctor their story of the violence and point out the area that is painful. Now the area around the eyes is examined and attention is paid to red skin discoloration. Since a glasses hematoma occurs on both sides, the diagnosis is quite clear.

Treating an eyeglass hematoma

How is an eyeglass hematoma treated?

If you have a spectacle hematoma, you can cool the affected area. The cooling pulls the injured vessels together and prevents further bleeding into the surrounding tissue. This, in turn, keeps the swelling as small as possible and keeps the pain as low as possible. Furthermore, the pain is not so well perceived by the cold. For cooling, we recommend a cool pack that is covered with fabric so that the fabric is not damaged by the cold.

A few days later, the healing of the affected area should be stimulated. Warm compresses help, as they increase blood flow and the leaked blood can be broken down more quickly. It is also advisable to put your head up at night so that any secretion can drain from the affected areas.

Care should be taken with creams and gels that thin the blood and thus help the hematoma to go away faster because the leaked blood is broken down more quickly. Such preparations are usually used for hematomas on the arms and legs and, if used incorrectly, can get into the eye and damage the conjunctiva. Accordingly, the use of these products should be clarified with the doctor. Herbal preparations with the active ingredient of the arnica plant can also be used for the healing process and for pain relief.

Here you can find out more about: Injuries to the eye

Causes of a glasses hematoma

What are the causes of a glasses hematoma?

If a hematoma is present, the cause is usually a fracture of the skull base. This is a bone fracture in the area of the base of the skull, which is caused by a strong force on the head. When the base of the skull fractures, many vessels are injured, which can lead to a hematoma of glasses. Another cause can be a fracture of the bony eye socket, which occurs as a result of punctual violence on this region. With such a fracture, if it is one-sided, there is only one hematoma. It is similar with injuries caused by violence on the soft tissues in the eye socket.

Spectacle hematoma after fracture of the base of the skull

A fracture of the base of the skull can be the cause of a spectacle hematoma, because in this severe head injury numerous vessels are severed, which can then bleed into the skin. The cause of a skull base fracture is physical violence, such as an impact in a traffic accident. In the case of a fracture of the base of the skull, the bone sutures in the area of the skull that connect the individual skull plates with one another break. The bone connections are the weakest points on the skull, as they only grow together completely in childhood. Which seams break apart is different and depends on the force of violence.

Find out more about the following topics:

Symptoms of a skull base fracture
Consequences of a skull base fracture
Duration of a skull base fracture

Spectacle hematoma after a fall

In the event of an uncontrolled fall, it cannot always be prevented that the head hits the ground. Usually you can catch or support yourself with your arms. If this is not the case, the external force applied to the skull can lead to a hematoma of the glasses.

A fall can have various causes, for example, it is possible that you slip on black ice, fall down stairs, fall on a bike or just stumble and go down. The more force you fall to the ground, the worse the consequences of a fall can be. The height from which you fall is also decisive, so falling down stairs, for example, is very dangerous and can lead to a hematoma of glasses, which can be caused by a fracture of the base of the skull.

Read more about the topic: Fall in old age

Course of a hematoma of glasses

What is the course of a spectacle hematoma?

A glasses hematoma is visible for at least seven days. On the first day after the violence on the eye region, the damaged tissue swells and the bruise turns red. The swelling and discoloration depend on the size of the vascular injuries.

After 24 - 96 hours, the bruise will turn black / blue. The color change is caused by the breakdown of the leaked blood. Now the color changes to dark green after about four days. From the 7th day on, the bruise is yellowish and begins to fade more and more. The swelling has usually subsided earlier. When the discoloration is no longer visible and the affected area is again insensitive to pressure, the hematoma of the glasses has healed.

What are the possible complications of a spectacle hematoma?

A complication of a glasses hematoma can be a skull base fracture. A fractured skull usually heals without any further complications and does not have any long-term effects. However, it is also possible that a fracture of the base of the skull leads to bleeding inside the skull. Furthermore, a fracture of the base of the skull can cause encephalitis and brain water can escape due to the strong force and the resulting injury. In addition, pus can accumulate in the region of the hematoma, in which case it is possible that an abscess has formed as a complication.

Read more about the topic here: Brain abscess and meningeal irritation

Further questions about a spectacle hematoma

What is a monocular hematoma?

A monocular hematoma is also colloquially known as “black eye” or “violet”. It is a bruise in the area of the upper and / or lower part of an eye. The hematoma therefore only occurs on one side compared to the spectacle hematoma. The monocular hematoma is usually the result of local violence, such as a blow or impact from an accident or fall. Boxing fighters are often affected by such a hematoma. Along with the hematoma, the bony structure around the eye can also be broken. The skin around the eye is bluish, tender, and painful until the bruise heals on its own.