# Black Eye (Periorbital Bruising) - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - Sources: ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class FD35.00 - condition scope only, no dose · Orbital Floor Fracture - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK534825/ · MSF Essential Drugs 2024 - paracetamol (oral) - Verified date: 2026-08 ## Verified against - MSF Essential Drugs 2024 - paracetamol (oral) ## Treatment metadata - Paracetamol — 500 mg — oral.solid - Referral & safety-netting (no drug therapy) ## Complete treatment card ```text BLACK EYE (PERIORBITAL BRUISING) Sources: ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class FD35.00 - condition scope only, no dose · Orbital Floor Fracture - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK534825/ · MSF Essential Drugs 2024 - paracetamol (oral) Review status: REVIEWED against the source listed above (2026-08) Rx: Pain | Main treatment PAIN 1. PARACETAMOL [1st line] Adult 1 g (two 500 mg tablets) 3 or 4 times daily, to a maximum of 4 g in 24 hours. - A few days, while the bruise is tender. Peds 15 mg/kg/dose [child max 500 mg] (Child 1 month and over: 15 mg/kg 3 or 4 times daily, to a maximum of 60 mg/kg in 24 hours. Child under 1 month: 10 mg/kg 3 or 4 times daily, to a maximum of 40 mg/kg in 24 hours. A single dose is capped at 500 mg because the top band of MSF's own weight table, 30 to under 50 kg, is one 500 mg tablet three times daily.) 3kg -> 45 mg/dose 4kg -> 60 mg/dose 5kg -> 75 mg/dose 6kg -> 90 mg/dose 7kg -> 105 mg/dose 8kg -> 120 mg/dose 9kg -> 135 mg/dose 10kg -> 150 mg/dose 11kg -> 165 mg/dose 12kg -> 180 mg/dose 13kg -> 195 mg/dose 14kg -> 210 mg/dose 15kg -> 225 mg/dose 16kg -> 240 mg/dose 17kg -> 255 mg/dose 18kg -> 270 mg/dose 19kg -> 285 mg/dose 20kg -> 300 mg/dose 21kg -> 315 mg/dose 22kg -> 330 mg/dose 23kg -> 345 mg/dose 24kg -> 360 mg/dose 25kg -> 375 mg/dose 26kg -> 390 mg/dose 27kg -> 405 mg/dose 28kg -> 420 mg/dose 29kg -> 435 mg/dose 30kg -> 450 mg/dose 31kg -> 465 mg/dose 32kg -> 480 mg/dose 33kg -> 495 mg/dose 34kg -> 500 mg/dose (capped) 35kg -> 500 mg/dose (capped) 36kg -> 500 mg/dose (capped) 37kg -> 500 mg/dose (capped) 38kg -> 500 mg/dose (capped) 39kg -> 500 mg/dose (capped) 40kg -> 500 mg/dose (capped) 41kg -> 500 mg/dose (capped) 42kg -> 500 mg/dose (capped) 43kg -> 500 mg/dose (capped) 44kg -> 500 mg/dose (capped) 45kg -> 500 mg/dose (capped) 46kg -> 500 mg/dose (capped) 47kg -> 500 mg/dose (capped) 48kg -> 500 mg/dose (capped) 49kg -> 500 mg/dose (capped) 50kg -> 500 mg/dose (capped) Source MSF Essential Drugs 2024 - paracetamol (oral) Why Periorbital bruising after blunt trauma is painful for several days once deeper injury has been excluded, and paracetamol is the analgesic MSF indicates for mild to moderate pain. The orbital floor fracture article that the card is built on names no analgesic and states no amount for any medicine, so both the indication and the amount are MSF's. Caution Pain relief is not the assessment. Reduced visual acuity, double vision, restricted eye movement suggesting an entrapped orbital fracture, or blood visible in the front of the eye needs urgent ophthalmology the same day. Where an orbital fracture is confirmed, the orbital floor fracture article requires prophylactic antibiotic cover for oral organisms and says corticosteroids may reduce the oedema - and it names no drug, no dose and no duration for either, so neither is printed. That choice belongs to the service the patient is referred to. Never exceed 4 g in 24 hours in an adult, or 60 mg/kg in 24 hours in a child. MSF warns that paracetamol poisoning is severe - it causes hepatic cytolysis - and that the stated limits matter most in children and in older patients. MSF records no contra-indication in pregnancy or in breast-feeding, and names paracetamol as the analgesic of choice for a patient allergic to aspirin, one with a history of gastric trouble, a pregnant or breast-feeding woman, and children. Paracetamol has no anti-inflammatory action, so it eases the pain and does nothing for the swelling. Egypt FEBRIMOL 500 MG 20 TAB. PHARCO 3.50 EGP (0.17/unit) CETAMOL 500 MG 20 TABS. MEMPHIS 8.00 EGP (0.40/unit) PARACETAMOL-MUP 500MG B.P. 20 TABS. MUP 13.00 EGP (0.65/unit) CETAL 500 MG 20 TABS. EIPICO 24.00 EGP (1.20/unit) ARKADOLOW 500 MG 30 F.C. TABS. UTOPIA 42.00 EGP (1.40/unit) PARAMOL 500MG 20 TAB. MISR 38.00 EGP (1.90/unit) ADOL 500MG 24 CAPLETS JULPHAR 32.00 EGP AUGICETAMIDE 500 MG 20 SACHETS AUG PHARMA 50.00 EGP FEBRIMOL ORAL DROPS 20 ML PHARCO 4.00 EGP -> ? strength differs, ? different route - not oral solid THERA-LO 3.2G/100ML ORAL SUSP. 100 ML PHAROPHARMA 5.00 EGP -> ? strength differs, ? different route - not oral solid MAIN TREATMENT 2. REFERRAL & SAFETY-NETTING (NO DRUG THERAPY) [1st line] Adult Bruising around the eye from blunt trauma; a GP checks for red flags of deeper injury such as an orbital fracture or globe injury and otherwise manages it with analgesia and reassurance. - Refer, with advice Peds A child is dosed from the drug rows above, by weight. The referral threshold and the safety-netting are the same at any age. Source No dose - referral pathway, no medicine given in primary care Why Bruising around the eye from blunt trauma; a GP checks for red flags of deeper injury such as an orbital fracture or globe injury and otherwise manages it with analgesia and reassurance. Caution The drug rows above are what the treating service gives. They are here so that the referral is an informed one and so the GP can recognise the regimen the patient comes back on - not as permission to start it without the referral. RED FLAG - Reduced visual acuity or double vision, restricted eye movement (possible orbital fracture with entrapment), or blood visible in the front of the eye (hyphaema): refer urgently. Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)