A "black eye" may not be a trivial injury. Frequently it is accompanied by fracture of the floor of the orbit. This gives rise, if uncorrected, to enophthalmos and diplopia. It is important that the attending physician be aware of this possible complication and request x-ray examination to exclude the possibility of associated fracture of the floor of the orbit at the time of injury. These points are exemplified in the case histories of 4 patients, all male, between the ages of 11 and 45.
Doubleday LC. Roentgenologic Aspects of the Black Eye. JAMA. 1962;179(1):27-29. doi:10.1001/jama.1962.03050010029006