What Is Chemosis?

Chemosis is an eye condition that affects the conjunctiva (the tissue that lines the inside of the eyelid) and the eye surface. It causes irritation and swelling. It may also be defined as an edema of the conjunctiva.

It may look like a blister or jelly-like substance covering the sclera (the white of the eye). It can also look like you have fluid trapped beneath the surface.

What Is the Role of the Conjunctiva?

The conjunctiva plays a key role in lubricating and protecting the eye. It not only protects the sclera (white of the eye); it also produces tears and mucus. 

The conjunctiva stops bad microbes from entering the eye and supports immune functioning. Home to an extensive network of lymphatic vessels, the conjunctiva is notably vascularized.

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Key Facts About Chemosis

The following facts will give you some key details about chemosis and how it may develop:

• Several events can cause chemosis, each of which requires a different therapy.
• The condition may be mild to severe. In severe cases, you can’t properly close your eyes.
• While the symptoms of chemosis are similar to viral or bacterial conjunctivitis, unlike conjunctivitis, chemosis is not contagious.
• Chemosis is often related to an allergic reaction.

What Causes Chemosis?

Chemosis may develop for one of various reasons. It may be triggered by the following:

• An allergy
• A bacterial or viral optical infection
• Some type of trauma, such as rubbing the eyes too much or getting struck by an object
• Eye surgery complications
• Hyperthyroidism

An Allergic Response

If chemosis develops from an allergy, hay fever, dust, pet hair, or some type of powder may be the trigger. When exposed to these allergens, the body produces histamines to combat them. This leads to swelling and potential blistering.

Virtual or Bacterial Conjunctivitis or Another Infection

Chemosis may be the result of viral or bacterial conjunctivitis or another type of infection. The swelling is the body’s attempt to protect itself.

Trauma

A direct hit to the eye or continual rubbing of the eyelid can also lead to the condition. Trauma leads to both irritation and inflammation. You may rub your eyes too much if you have problems with dry eye or itchiness.

Hyperthyroidism

Thyroid eye disease (TED), or Graves’ ophthalmopathy can threaten vision if not treated. It also contributes to eye irritations, such as chemosis.

What Are the Symptoms of Chemosis?

Chemosis produces various symptoms, including the following:

• Itchy eyes
• Excessive tearing
• Blurred vision
• Problems with focus

The most noticeable sign of chemosis is the blister appearance of the outer surface of the eye or the appearance of fluid beneath the conjunctiva over the sclera. If chemosis develops from an allergy or eye infection, your eyes may look red.

If the reaction is allergic, you might also have problems with breathing and a fast heart rate or facial swelling.

How Is Chemosis Diagnosed?

Your eye doctor can diagnose chemosis via a visual examination and gathering information about your medical history. They can use this information to treat the underlying cause of the eye irritation.

Risk Factors for Chemosis 

Your chances of developing chemosis increase if you have eye surgery or suffer from allergies. People with gonorrhea and newborns exposed to gonococcal conjunctivitis are at an increased risk too. Smoking also decreases immunity, which can lead to chemosis.

ICU Care or Surgery After-Care

Chemosis often presents as ocular surface disease (OSD) in the ICU, so the risk of its development after surgery or after receiving emergency treatment is high.

Allergy

If you have trouble breathing along with chemosis, seek medical care right away. This should be considered a medical emergency. 

Newborn Infections & Conjunctivitis

Chemosis, associated with neonatal conjunctivitis, may occur within the first 30 days after birth. This eye problem may result from a viral or bacterial infection, or from the use of chemicals, primarily silver nitrate, to treat gonococcal conjunctivitis. 

If not treated properly, the condition can lead to conjunctival hyperemia or permanent scarring and blindness. 

Smoking

Smoking reduces immunity, which increases the risk of chemosis. This factor also affects people with thyroid eye disease (TED), as patients who smoke have more problems with eye irritation, including swelling and inflammation.

Ways to Prevent Chemosis

You can prevent chemosis by addressing the conditions that lead to eye irritation. These conditions may include allergies, trauma, after-surgery complications, or eye infections.

Treat Your Allergies

If your chemosis develops from an allergy, it is important to treat the allergy to prevent the return of chemosis. This may include taking allergy medicines or learning ways to avoid exposure to allergens.

Follow Your Doctor’s Orders Regarding Postsurgical Care

Strictly follow your doctor’s orders if you undergo eye surgery, as an eye procedure may lead to unwanted irritation of the eye. Use any prescribed medications, such as antibiotics, to prevent infection.

Refrain From Rubbing Your Eyes Too Much

Many people develop chemosis if they rub their eyes too hard or continually scratch itchy eyes. Because itchy eyes are a symptom of chemosis, this can turn into an ongoing problem.

Refrain from rubbing the eyes as much as possible. If your eyes itch, treat them with eye drops or ask your eye doctor for ways to resolve the discomfort. If chemosis develops, using cold compresses will help to clear up the condition.

Treat Eye Infections With Eye Drops or a Cold Compress

If you have a bacterial eye infection, you can prevent further problems by lubricating the eyes or using antibiotic eye drops in severe cases. Viral eye infections may also lead to chemosis, so the use of cold compresses and hydrating eye drops can prevent chemosis from developing.

Don’t Smoke

Smoking is simply not good for you. It weakens the immune system, which also opens you up to a host of problems.

Treatment Options for Chemosis

Depending on the severity of the eye irritation, you can treat chemosis using one or more therapies. From eye drops to antihistamines to cold compresses, you can find relief for the condition. Here are some treatment options:

Eye Drops

Whether you’re caring for your eyes after eye surgery or treating a viral or bacterial infection, eye drops can help to moisten the eyes, so you can manage the conditions that trigger chemosis.

Allergy Treatments

If your chemosis develops from an allergic response, treating the underlying condition, or the allergy, will also prevent the development of chemosis. Over-the-counter antihistamines are often the best choice to treat allergies. If these don’t adequately treat the issue, see an allergist.

Cold Compresses

Cold compresses may be used to reduce swelling associated with chemosis and bring relief from related discomfort.

Chemosis FAQs 

When is chemosis considered severe?

If you cannot shut your eyes or your symptoms last over a week, you need to see your doctor immediately. If your chemosis is allergy-induced and you’re having trouble breathing, get medical help right away.

How long does chemosis last?

Depending on the extent of the eye irritation, chemosis may last from several days or weeks to months at a time. In minor cases, when you use cold compresses or rest your eyes, the irritation usually goes away quickly. 

On average, chemosis lasts about four weeks. Its duration ranges from one week to three months.

Which eye drops are good for chemosis?

If your chemosis develops from a bacterial infection, bacterial eye drops will help to treat the irritation. Lubricating eye drops are helpful for chemosis that is triggered from a viral infection. 

Can dry eye lead to chemosis?

Dry eye can lead to chemosis, especially if you rub your eyes a lot or don’t lubricate them sufficiently. Also, dry eye often appears with chemosis after a surgical procedure, such as blepharoplasty.

Is chemosis serious?

Severe chemosis can cause such severe swelling that the eye cannot close. See an eye doctor immediately if this occurs. It’s always better to see a doctor sooner to minimize long-term harm.

References

1. Intraoperative Chemosis During Resection of Lower Eyelid Lesion. (September 2015). ePlasty.

2. Anatomy, Head and Neck, Eye Conjunctiva. (August 2022). StatPearls.

3. Hyperthyroidism (Overactive Thyroid). (August 2021). National Institute of Diabetes and Digestive and Kidney Diseases.

4. How to Recognize & Treat Thyroid Eye Disease. (November 2013). Review of Ophthalmology.

5. Eye Care in the Intensive Care Unit. (March 2018). Journal of the Intensive Care Society.

6. Neonatal Conjunctivitis. (January 2023). EyeWiki, American Academy of Ophthalmology.

7. Overview of Conjunctivitis. (September 2022). MSD Manual Professional Version.

8. Gonococcal Conjunctivitis. (September 2022). StatPearls.

9. Dry Eye Symptoms and Chemosis Appear Common Following Blepharoplasty. (January 2013). American Academy of Ophthalmology.

10. Blepharoplasty: An Overview. (January–June 2019). Journal of Cutaneous and Aesthetic Surgery.

11. Conjunctival Chemosis or Not? (October 2018). Indian Journal of Ophthalmology.

12. Chemosis From Trauma. (July 2014). West JEM.

13. Ocular Chemosis, Hyperaemia, Extroversion and Exophthalmos After Facial Trauma. (May 2021). Emergency Medical Journal.