From the Guidelines
Treatment for eye chemosis primarily involves addressing the underlying cause, and for adenoviral conjunctivitis, a common cause of chemosis, topical corticosteroids may be used to reduce symptoms and inflammation, as suggested by the most recent study 1.
Causes and Symptoms
The majority of cases of acute, infectious conjunctivitis in the adult population are viral and self-limited, and adenoviral conjunctivitis is a common cause of chemosis. Patients with adenoviral conjunctivitis need to understand that the condition is highly contagious and that this is a hearty virus that can survive for many weeks on a countertop or similar surface if careful disinfection doesn’t occur.
Treatment Options
Some key points to consider in the treatment of eye chemosis include:
- Artificial tears, such as Systane or Refresh Tears, applied 4-6 times daily to help lubricate the eye and reduce swelling.
- Cold compresses applied for 10-15 minutes several times daily to decrease inflammation and provide comfort.
- Antihistamine eye drops, such as ketotifen (Zaditor) or olopatadine (Pataday), used twice daily if allergies are causing the chemosis.
- Prescription steroid eye drops, like prednisolone acetate 1% used 4 times daily for 5-7 days (with proper tapering), might be necessary under medical supervision for more severe cases.
- Topical corticosteroids, as suggested by the study 1, may be used to reduce symptoms and inflammation in adenoviral conjunctivitis.
Important Considerations
It's essential to avoid rubbing the eyes, as this can worsen swelling. If chemosis persists beyond a few days, is associated with pain, vision changes, or occurs after eye surgery or trauma, immediate medical attention is necessary, as these could indicate serious conditions requiring prompt intervention. The use of antibiotics in the management of viral infections should be avoided due to potential adverse treatment effects, as noted in the study 1.
Additional Measures
In cases of adenoviral conjunctivitis, patients should be educated about measures that will help reduce the spread of this infection, such as minimizing contact with other people for 10 to 14 days from the onset of symptoms in the last eye affected, and careful disinfection of surfaces to prevent the spread of the virus, as suggested by the study 1.
From the Research
Treatment for Eye Chemosis
- The treatment for eye chemosis, a common complication of blepharoplasty surgery, typically involves a stepwise approach, starting with lubricants and escalating to increasingly potent anti-inflammatories, with compression bandaging and surgery reserved for persistent cases 2.
- A study on the comprehensive management of chemosis following cosmetic lower blepharoplasty found that successful treatment existed along a continuum from liberal lubrication to ophthalmic steroid preparations and ocular decongestants to eye-patching to minor surgical procedures such as drainage conjunctivotomy and temporary tarsorrhaphy 3.
- In cases of acute viral conjunctivitis, artificial tears alone may be sufficient for treatment, as a study found no significant difference in symptom and sign scores between patients treated with artificial tears alone and those treated with 0.45% ketorolac tromethamine + carboxymethylcellulose 4.
- Oral antihistamines, such as diphenhydramine and loratadine, may have varying effects on tear volume, tear stability, and intraocular pressure, with diphenhydramine decreasing tear volume and loratadine having fewer reservations for use with dry eye treatments 5.
- The optimum artificial tear treatment for dry eye disease may depend on individual patient characteristics, such as baseline tear volume and lipid layer thickness, with some patients preferring certain artificial tears over others 6.