From the Guidelines
Chemosis of the eye is primarily caused by fluid accumulation in the conjunctiva, often resulting from allergic reactions, eye infections, trauma, or systemic conditions, as supported by the most recent evidence from 2024 1. The causes of chemosis can be diverse, including:
- Allergic reactions to substances like pollen, pet dander, or certain medications
- Eye infections such as bacterial or viral conjunctivitis
- Trauma to the eye
- Excessive eye rubbing
- Systemic conditions like thyroid eye disease or angioedema
- Post-eye surgery complications
- Contact lens irritation
- Environmental irritants The swelling occurs due to inflammatory mediators causing blood vessels in the conjunctiva to become more permeable, allowing fluid to leak into the surrounding tissue, as described in the context of atopic eye disease 1. It is essential to identify and address the underlying cause of chemosis, as it may indicate more serious conditions such as orbital cellulitis or cavernous sinus thrombosis, and treatment may include antihistamines for allergies, antibiotics for bacterial infections, or corticosteroids for severe inflammation, as noted in the management of conjunctivitis 1. In cases of severe disease, such as adenoviral keratoconjunctivitis with marked chemosis, topical corticosteroids may be helpful in reducing symptoms and scarring, but close follow-up is warranted due to potential adverse treatment effects 1. Overall, the management of chemosis depends on the underlying cause and may involve a range of treatments, from topical medications to more invasive procedures, as discussed in the context of dry eye syndrome and ocular surface disorders 1.
From the FDA Drug Label
Ocular adverse reactions occurring in 5-15% of patients treated with loteprednol etabonate ophthalmic suspension (0.2-0. 5%) in clinical studies included abnormal vision/blurring, burning on instillation, chemosis, discharge, dry eyes, epiphora, foreign body sensation, itching, injection, and photophobia.
The cause of chemosis of the eye is not explicitly stated in the drug label as being directly related to a specific factor, but it is listed as an ocular adverse reaction that occurred in 5-15% of patients treated with loteprednol etabonate ophthalmic suspension 2.
From the Research
Causes of Chemosis of the Eye
Chemosis of the eye can be caused by various factors, including:
- Excess fluid in the conjunctiva, which can lead to conjunctival edema 3
- Postoperative lymphatic dysfunction, periorbital edema, and exposure after cosmetic lower blepharoplasty 4
- Allergic reactions, such as allergic conjunctivitis, which can be caused by airborne allergens, topical and systemic drugs, cosmetics, or animal hairs 5
- Medication side effects, such as those associated with amlodipine besylate (Norvasc) 6
- Surgical complications, such as those occurring after lower eyelid blepharoplasty 4, 7
Types of Chemosis
Different types of chemosis can occur, including:
- Acute mild chemosis with complete lid closure (type 1) 4
- Acute severe chemosis that prohibits complete lid closure (type 2) 4
- Subchronic chemosis that persists longer than 3 weeks (type 3) 4
- Chemosis associated with lower lid malposition (type 4) 4
- Chronic localized conjunctival chemosis (CLCC), which can result from scarring and structural alteration of conjunctival lymphatics 3
Associated Factors
Associated factors that can contribute to chemosis include: