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What Are ‘Raccoon Eyes’? Causes, Symptoms, Treatment

Medically Reviewed by Whitney Seltman, OD on July 08, 2020

Raccoon eyes are dark purple or blue bruises under your eyes. The name comes from their resemblance to the dark circles under a raccoon's eyes.

Doctors sometimes call raccoon eyes periorbital ecchymosis. "Periorbital" means "around the eyes." "Ecchymosis" is a change in color.

Raccoon eyes can appear after an injury or illness that causes tiny blood vessels to bleed into the skin under the eyes. They're not the same as the dark circles you get when you're tired. Those dark circles are much more mild and aren't from a medical condition.

Raccoon eyes are a symptom, not a disease. They aren't dangerous themselves, but they could be a sign of a serious head or eye injury. Consult a doctor, and do that right away if you’ve recently had an injury.

What Causes Them?

Raccoon eyes are usually a symptom of an injury to the eyes or head. Injuries can stretch and tear tiny blood vessels called capillaries under your eyes. Blood leaks into the skin and turns it a dark purple color. Because the skin under your eyes is very delicate, even a minor injury can cause a lot of blood to pool underneath.

Fractures to the face and other head injuries can cause raccoon eyes, although you may not notice them right away. It can take 1 to 3 days after the injury for the dark color to appear.

Raccoon eyes can also be a symptom of certain systemic conditions, but that’s not the most likely case.

They can happen with primary amyloidosis, a disease that causes an abnormal protein to build up in tissues around the body. Primary amyloidosis can weaken blood vessels so much that a strong sneeze or cough is enough to break them.

Other diseases that weaken or stretch the blood vessels can also cause raccoon eyes, including:

Some cancers have raccoon eyes as one of their symptoms, including:

Surgery on the ear, eye, sinuses, or nose can also cause raccoon eyes.

What Else You Might Have

Which other symptoms you have depends on the condition that caused your raccoon eyes. Other symptoms of a skull fracture include:

  • A lump or swelling on the head
  • Headache
  • Confusion or dizziness
  • Nausea or vomiting
  • Bruising behind the ear
  • Clear fluid draining from your nose or ears

Amyloidosis causes symptoms like these:

  • Tiredness and weakness
  • Shortness of breath
  • Swelling in the ankles and legs
  • Numbness or tingling in the hands and feet
  • Weight loss

Treatments for Raccoon Eyes

The skin problem itself probably doesn’t need treatment. But if you had a head injury, you’ll need medical help right away.

You might need a computed tomography (CT) scan to look for signs of injury in your brain. You may need surgery for a severe fracture or other head injury to remove a clot, fix broken blood vessels, or remove broken pieces of bone. And if you had a concussion, that needs medical care and rest. Most skull fractures will also heal by themselves, but the process can take a few months.

Raccoon eyes should go away on their own, although it can take up to 2 weeks. It's normal for the color to change from purple to green or yellow as you heal. That's the blood reabsorbing into your skin. Apply ice packs to your closed eyes to bring down any swelling.

Show Sources

SOURCES:

American Academy of Ophthalmology: "Evaluation and Management of Orbital Hemorrhage."

Amyloidosis Foundation: "Symptoms."

BMC Nephrology: "A 64-year-old woman with raccoon eyes following kidney biopsy: a case report."

BMJ Case Reports: "Spontaneous periorbital ecchymosis: a rare presentation of acute lymphoblastic leukaemia."

Case Reports in Gastroenterology: "Periorbital Ecchymosis (Raccoon Eye) and Orbital Hematoma following Endoscopic Retrograde Cholangiopancreatograpy."

Fleisher, G. Textbook of Pediatric Emergency Medicine, 2010.

Mayo Clinic: "Amyloidosis," "Dark circles under eyes."

National Health Service (U.K.): "Skull fracture," "Treatment: Severe head injury."

StatPearls: "Raccoon sign."

UC Health: "Skull fractures."

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