The appearance of bruising around the eyes, medically known as periorbital hematoma or “black eyes,” is a common result of a nasal fracture. This symptom occurs frequently because of the interconnected nature of the facial structures and the delicacy of the skin surrounding the orbit. This discoloration is a sign that the force which broke the nose also caused damage to nearby blood vessels. The swelling and bruising are the body’s natural reaction to injury.
How a Broken Nose Leads to Black Eyes
A broken nose, or nasal fracture, involves the bone and cartilage structure of the central face, which is richly supplied with small blood vessels. When fractured by trauma, these tiny vessels rupture, leading to internal bleeding beneath the skin. This collection of blood is called a hematoma, and its formation is the underlying cause of the bruising.
The blood initially collects near the site of the impact, typically over the nasal bridge and the bones of the mid-face. The skin and tissues around the eyes are particularly loose and contain very little fat, making them a region where fluid and blood can easily accumulate. Because of gravity, the free blood from the nasal fracture site begins to seep and track downward.
This downward migration of blood pools into the highly flexible tissue surrounding the eye sockets, causing the characteristic dark discoloration. Bruising can affect one or both eyes, depending on the severity and location of the fracture. The resulting swelling and discoloration are a direct consequence of this internal bleeding spreading to the loose periorbital area.
Timeline for Bruising Appearance
The onset of black eyes following a broken nose can vary, but the bruising typically appears quickly, often within the first few hours after the injury. In cases of significant trauma, the discoloration may be noticeable almost immediately. The initial darkening is due to the fresh pooling of blood beneath the thin skin.
The bruising usually becomes most prominent and severe about 24 to 48 hours following the injury. During this period, swelling and discoloration increase as more blood seeps into the area. The color typically starts as red or dark purple before progressing to blue or black as the blood loses oxygen.
Several factors can influence how quickly and severely the bruising develops, including the intensity of the trauma and the exact location of the fracture. A more severe fracture that causes greater blood vessel damage will lead to faster and more widespread bruising. Individual factors, such as the use of blood-thinning medications, can also increase the rate and extent of the hematoma formation.
As the body breaks down the pooled blood, the bruise will begin to change color, fading to green and yellow around five to ten days post-injury. While the discoloration appears quickly, the entire process of the bruise fading fully can take two to three weeks.
Recognizing Associated Signs and Seeking Care
A broken nose is frequently accompanied by other noticeable symptoms. These signs include pain, tenderness when touching the nose, a nosebleed, and a crunching or crackling sound upon contact. Difficulty breathing through the nose is also common, caused by swelling and possible misalignment of the nasal structures.
It is important to seek medical evaluation for a broken nose, especially if the nose appears visibly crooked or misshapen after the initial swelling subsides. Immediate care is necessary if the black eyes are accompanied by symptoms suggesting a more extensive injury. Signs such as double vision, inability to move the eye, or clear, watery fluid draining from the nose may indicate a fracture of the orbital bone or a more serious head injury.
Another serious concern is a septal hematoma, which is a collection of blood on the nasal septum that must be promptly drained by a doctor. Ignoring these symptoms can lead to complications, including persistent breathing problems or vision changes. A healthcare provider can assess the full extent of the damage, which may involve checking for other facial fractures.