Hi. It appears that your nephew has been getting recurrent bleeding around his eyes and now through his nose. This points to a bleeding disorder as he seems to bleed easily. The black discolouration in the swelling around the eye is most commonly seen due to bleeding in that region. The nose bleeding suggests that it could have been some sort of injury that your nephew has repeatedly (Does he fall down too frequently or get into fights with other kids you may need to find out) or he may be bleeding spontaneously which could mean a bleeding disorder. He needs a blood work up to assess his bleeding and clotting time along with APTT, PT, Factor 8, as well as platelet counts. Also any history of developing bruises easily or taking abnormally long to stop bleeding are relevant and must be shared with his primary physician. Here is some trivia on how to manage nose bleeds: Step1 - Do not make the child lie down or lift his head upwards. Rather make him sit up and bend forwards with his mouth open (place a container beneath) and take deep breaths from his mouth. (By lying down you are not stopping the bleeding but in fact increasing the chance for the blood to enter the lungs which can be fatal or into the stomach which will create gastric irritation and vomiting) Step 2- Pinch the nose strongly at the soft part of the nose at a point where it is closest to the bony region for at least 10 to 15 minutes while maintaining firm pressure. our normal bleeding time is around 10 minutes so it is important to follow this step religiously. Step 3- If step 2 does not work then repeat it again while keeping an ice pack over the nose to help stop the bleeding faster. Step 4 - Most important step! After the nose pinching, the nose will feel blocked because of a blood clot that has helped stop the bleeding. Please do not try to clear the nose by sneezing or rubbing the nose excessively. It will bleed from the nose again and will have to start all over from step 1