Your kid comes home from school with a black eye. You immediately start asking questions; they say they had a fall from the playground and they bashed it against the ground, but you wonder whether or not they’re getting into schoolyard fights. You’re also wondering how urgent the black eye is; obviously, it’s unsightly, but can it cause damage to your child’s vision? How should you best care for it, and what are the signs to look out for?

Black eyes are caused by damage to blood vessels around the eye; they are known medically as periorbital hematomas. When the blood vessels are damaged, it can cause blood to pool near the surface of the skin; the skin around your eyes is quite thin and somewhat transparent, which is why black eyes are so visually striking compared to bruises you might get on the rest of your body. It’s pretty easy to end up with a black eye; blunt force trauma around the eye, caused by anything from a sports accident or a fall from the playground, can result in the condition. Black eyes can occur due to circumstances other than blunt force trauma; infections in surrounding tissue and facial surgery can also result in black eyes.

While black eyes occur around the eye, they can be accompanied by injuries to the eye itself. One such condition, a subconjunctival hemorrhage, will cause the whites of the eye to become red. While these hemorrhages can look pretty scary, they are for the most part no more severe than a black eye, and will heal on their own without intervention. Another condition, known as hyphema, is notable because the blood seems to pool near the front of the iris, obscuring it with blood. This condition is a medical emergency, as when blood pools in the eye, intraocular pressure can rapidly increase, causing damage to the ocular nerve (glaucoma). Should you notice signs of hyphema, get an eye exam done right away.

Black eyes can be treated in much the same way you would treat any other bruise. Getting a cold pack on the eye to reduce pain and swelling. After the first day or two, it’s a good idea to switch to a warm compress, because they can encourage blood flow to the eye, which will make the bruise heal more rapidly. Should you experience pain, you can always use a non-steroidal anti-inflammatory drug (NSAID) like ibuprofen in order to reduce it; prolonged or severe pain might be a sign of concern, and should be checked by a medical professional.

There are other signs that you should go see an optometrist or a physician; should you experience mood changes, lethargy, vomiting, fatigue, or dizziness, it may be a sign of concussion or other head trauma. If you’re unsure whether or not an injury warrants a visit to a medical professional, err on the side of caution and get it checked out; better to be safe than sorry with any kind of eye or head injury.