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Chemosis: Causes, symptoms and treatment

Depiction of the allergic infection chemosis

Chemosis is a swelling of the thin membrane that covers the eye. When you have chemosis, your eyelids and the white part of your eye might look red and puffy. In chemosis, the membrane (conjunctiva) that covers the white part of your eye (sclera) swells. 

The fluid buildup under the membrane in chemosis (pronounced “key-MOE-sis”) can make it look like you have a big, red blister on your eye. 

When you get a diagnosis, you may hear the eye care provider use the full name of this condition: conjunctival chemosis. 

Conjunctival chemosis vs. conjunctivitis

Conjunctivitis, commonly known as “pink eye,” is an inflammation or infection of the conjunctiva. It may be caused by an allergic reaction or a bacterial or viral infection. Both conjunctivitis and chemosis affect the conjunctiva, the thin membrane covering the front of the eye and they share some of the same causes. Here’s the definition of chemosis vs. conjunctivitis:

  • Conjunctivitis refers to inflammation of the conjunctiva

  • Chemosis refers to swelling (edema) of the conjunctiva 

You can get diagnosed with both conjunctivitis and chemosis at the same time. Both conditions may have the same underlying cause and can affect one or both eyes.

Symptoms of chemosis

The most common chemosis eye symptoms include: eye irritation, swollen eyelids, itchiness and watery eyes. You might also feel like you have something in your eye. The obvious sign of chemosis is swelling on the white of the eye that looks like a pink or red blister. This swelling is caused by fluid that builds up in the eye.

If you have severe chemosis, your eye might become so swollen that it can’t close. If this happens, you need to see an eye care provider right away. It’s important to be able to close your eyes because the eyelid protects the eye from dust and other irritants and can keep the eye from getting damaged.

Chemosis can be uncomfortable and irritating but generally does not cause pain, according to the American Academy of Ophthalmology (AAO).

Chemosis causes

There are several common causes of chemosis eye issues. These causes might include:

  • Angioedema — A condition that causes hives under the skin, angioedema can affect the eyes. Angioedema may be caused by: an allergic reaction to animal dander, food, pollen, medication or an insect bite. It can also be caused by exposure to hot or cold conditions, or by an autoimmune condition.

  • Allergies — Even if you don’t develop angioedema, seasonal or other allergies can cause chemosis.

  • An eye infection — An eye infection caused by bacteria or a virus can lead to chemosis. Your eye care provider may be able to do a test to see if an infection is causing your condition.

  • Eye surgery — Chemosis sometimes occurs as a complication after eyelid surgery. Patients who have eyelid surgery (blepharoplasty) for cosmetic or medical reasons may develop conjunctival chemosis during recovery.

  • Physical trauma — Sometimes simply rubbing the eye can cause chemosis. The condition can also be caused by an eye injury. This type of chemosis is known as traumatic chemosis.

  • A thyroid condition — In some cases, an underlying medical condition like a thyroid issue can cause chemosis.  

Chemosis eye treatment

Treatment for chemosis eye problems varies based on the cause. In some cases, you’ll need to take medication or use eyedrops to make chemosis go away. If your conjunctival chemosis is caused by irritation, cold compresses and rest might do the trick. 

Common treatments for chemosis include: antihistamines, eye drops, eye ointment or even surgery to fix a problem with the way the eye closes.

Antibiotics for chemosis

You might need to take antibiotics if your chemosis is caused by a bacterial eye infection. It’s important to see an eye care provider right away if you might have an eye infection. Taking prescription antibiotic eye drops can quickly clear up a bacterial eye infection that is causing chemosis. However, antibiotics won’t work for a viral eye infection. 

Antihistamines for chemosis

Is your chemosis caused by allergies? Your eye care provider might recommend over-the-counter antihistamines to reduce inflammation of the eye and chemosis caused by allergies ranging from a reaction to pet dander or pollen to a new laundry detergent. Common antihistamine brand names include Allegra, Benadryl and Claritin.

Eye drops for chemosis 

Artificial tears or eye drops may help to keep your eye moist and reduce eye irritation that is causing chemosis. You can buy artificial tears and some lubricating eye ointments over the counter or get them from your ECP. If you have severe or recurring chemosis, your eye care provider may prescribe anti-inflammatory or steroid eye drops.

Eye surgery for chemosis

For very severe chemosis, an eye care provider may need to perform a procedure. For example, your eye care provider might have to drain fluid from your eye by making a small incision. This is a quick in-office procedure that helps to reduce the pressure on your eye.

If you have chronic chemosis after eyelid surgery, an oculoplastic surgeon might need to do a second surgery to reposition the eyelid. In some cases, chronic chemosis results from a mechanical problem with the way the eye opens and closes, and corrective surgery may fix this problem.

Home remedies for chemosis 

It’s important to see your eye care provider if you have symptoms of conjunctivitis or chemosis. Your doctor will do an eye exam and ask questions about your symptoms to find the cause of your chemosis. Depending on the cause, the doctor may prescribe antibiotics or recommend a home remedy or over-the-counter medication.

Depending on the cause of your chemosis, there might be steps you can take at home to lessen the irritation. The most common home remedy for chemosis is putting cool compresses on your affected eye or eyes. This can relieve irritation as you recover.

How long does chemosis last?

Chemosis can last anywhere from a few days to weeks or months. In rare cases, chemosis may last for a year or longer.

The length of time chemosis lasts depends on the cause and severity of the chemosis. Mild chemosis caused by minor eye irritation can go away quickly. But severe chemosis after surgery or an eye injury can last much longer or even turn into a chronic condition.

Is chemosis dangerous to eye health?

Chemosis typically is not dangerous or serious. But chemosis can be irritating and even frustrating if it lasts for weeks or becomes chronic. In some cases, you might need to work with your eye care provider to find the right chemosis treatment for you.

Getting an exam and treatment from an eye care provider as quickly as possible may increase your odds of getting rid of chemosis fast.

When to see an eye care provider for chemosis

Because conjunctival chemosis has many causes and can’t be diagnosed at home, it’s important to see an eye care provider if you have symptoms. Make an appointment right away if your symptoms don’t go away or you experience any of these problems:

Your ECP will give you a diagnosis and offer treatment to get you on the road to recovery from chemosis. 

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