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Chemosis

Chemosis: Causes, Symptoms, Diagnosis, Treatment, and Prevention

A condition known as chemosis causes swelling of the conjunctiva, a thin membrane covering the white part of the eye and the inner surface of the eyelids. In addition to allergies, infections, eye surgeries, or excessive rubbing of the eye, chemo can cause chemosis to appear like a blister or bubble. The condition is usually not serious, but it can affect your vision and be uncomfortable. 

Causes of Chemosis

The main cause of chemosis is irritation of the eye. This can be triggered by different factors, such as:

  • The most common cause of chemosis is allergies. Seasonal changes, pollen, dust, pet dander, and other allergens can cause your eyes to itch, water, and swell. If you rub your eyes, you may damage the conjunctiva.

  • Chemosis can also be caused by infections, particularly ones that affect the conjunctiva. Viral or bacterial conjunctivitis can cause your eyes to become inflamed, sticky, and sensitive to light as well as cause chemosis. Infections such as orbital cellulitis or dacryocystitis can also cause chemosis as a consequence.

  • LASIK, cataract removal, and eyelid surgery can cause chemosis as a side effect. Surgery can damage the conjunctiva or cause inflammation or bleeding in the eye. With proper care and medication, chemosis usually resolves within a few days after surgery.

  • If your thyroid gland produces too much thyroid hormone, you may develop hyperthyroidism. Hyperthyroidism can affect your metabolism, heart rate, and body temperature. Also, hyperthyroidism can cause eye problems, such as bulging eyes, retraction of the eyelids, and chemosis. As a result of thyroid hormone stimulation, swelling and pressure can occur around the eyes.

  • Excessive rubbing: Excessive rubbing of the eye can also lead to chemosis. Inflammation and fluid accumulation can result from rubbing your eye, which can irritate the conjunctiva and cause friction or trauma. In addition to introducing bacteria or dirt into your eye, rubbing can cause infection as well.

Other less common causes of chemosis include:

  • It can cause severe pain, blurred vision, nausea, and headache. Acute glaucoma can also cause chemosis because of the high pressure that pushes fluid out of the eye and into the conjunctiva.

  • Symptoms of superior vena cava obstruction: The superior vena cava transports blood from the upper body to the heart in a large vein. When this vein is blocked by a tumor, blood clot, or infection, it can cause a condition called superior vena cava syndrome. It can cause swelling of the face, neck, arms, and chest. Additionally, it can cause chemosis when blood backs up in the veins of the eyes and causes fluid leakage.

  • Cluster headaches: Cluster headaches are severe headaches that occur in clusters or cycles. They usually affect one side of the head and are accompanied by symptoms such as redness, tearing, and drooping of the eye. Additionally, cluster headaches can cause chemosis because the pain and inflammation can adversely affect the eye's blood vessels and nerves.

  • An allergy, an infection, stress, or medication can cause urticaria, also called hives, a skin reaction that causes red, itchy, and raised welts on the body. It is also possible for urticaria to affect the eyes and cause chemosis as histamine released by the immune system causes swelling and fluid retention.

  • The orbital rhabdomyosarcoma is a rare type of cancer that affects the eyes' muscles. It usually affects children and young adults. As the tumor grows and compresses the eye and surrounding structures, rhabdomyosarcoma of the orbit can cause chemosis.

  • Chemosis can also be caused by parasitic infections, such as toxocariasis and loiasis. Toxocariasis is caused by roundworms and affects the eyes, liver, lungs, and brain. Loiasis is caused by a parasite that can invade the skin, blood, and eyes. Both parasites can cause chemosis as they can damage the conjunctiva and cause inflammation and fluid accumulation.

  • Systemic lupus erythematosus: Lupus is a type of autoimmune disease that causes inflammation and damage to the body's organs and tissues. It is possible for lupus to affect the eyes, causing dryness, redness, pain, and sensitivity to light. It is also possible for lupus to cause chemosis, a swelling and fluid retention caused by the immune system attacking the conjunctiva.

  • This condition causes the deeper layers of the skin and mucous membranes to swell. Angioedema can be caused by allergies, medications, infections, or genetics. As the swelling spreads to the conjunctiva and causes fluid accumulation, angioedema can cause chemosis in the eyes.

  • Carotid cavernous fistula: When there is an abnormal connection between the carotid artery and the cavernous sinus, this condition is known as carotid cavernous fistula. Carotid cavernous fistulas are major blood vessels that supply the brain with oxygen. Cavernous sinuses drain blood from the face and the eye. As high-pressure blood leaks from the artery and causes fluid retention in the eye, carotid cavernous fistulas can cause chemosis.

Symptoms of Chemosis

Swelling of the conjunctiva is the main symptom of chemosis. Swelling can vary in size, shape, and location. It can affect either one or both eyes. Swelling can make the eye seem like it has a blister or bubble on it, or it can cause the eye to protrude or bulge out of its socket as a result of the swelling.

Other symptoms of chemosis may include:

  • Chemosis can cause eye irritation, discomfort, and foreign body sensations. You may also experience burning, stinging, or itching.

  • Symptoms of chemosis can include watery eyes or excessive tearing. This is due to the swelling in the eye blocking the drainage of tears. Tears can also wash away the protective layer of mucus and oil that keeps the eye lubricated.

  • Chemosis can cause red eyes or conjunctival injection because swelling can compress the blood vessels in the eye and cause them to dilate or rupture. The redness can also be due to inflammation or infection.

  • In addition to blurry vision, chemosis can also cause double vision or strabismus due to the swelling distorting the shape of the eye and affecting the refraction of light.

  • Chemosis can cause difficulty closing the eye or lagophthalmos. This is because the swelling prevents the eyelids from covering the eye properly, causing dryness, irritation, or injury.

Diagnosis of Chemosis

Chemosis is usually diagnosed by looking at the appearance and history of the eye. Your doctor will examine your eye and examine your symptoms, medical history, and possible triggers.

Your doctor may also perform some tests to confirm the diagnosis and rule out other conditions that can cause similar symptoms, such as:

  • Slit-lamp examination: A slit-lamp examination is a test that uses a special microscope and a bright light to examine the structures of the eye in detail. Your doctor will use this test to check the extent and severity of the swelling, as well as any signs of inflammation, infection, or injury to the eye.

  • Fluorescein staining: FThis type of examination uses a bright light and a special microscope to examine the eye structures in detail. As well as checking for any signs of inflammation, infection, or injury to your eye, your doctor will use this test to assess the extent and severity of the swellingrs, or foreign bodies in the eye.

  • A Schirmer’s test measures the amount of tears produced by your eyes. Your doctor will put a strip of filter paper under your lower eyelid and ask you to close your eyes for five minutes. This test will be used to determine if your eyes are dry or deficient in tears.

  • A skin prick test, blood test, or patch test may be performed by your doctor to identify your allergies to common allergens, such as pollen, dust, pet dander, or cosmetics.

  • The blood test analyzes a sample of blood taken from a vein or finger and looks for signs of infection, inflammation, or autoimmune diseases that can cause chemosis. In addition to thyroid hormone, blood sugar, and other substances that can affect your eyes, blood tests can also measure your blood sugar levels.

  • The purpose of imaging tests is to create images of the inside of the body using a variety of techniques. In order to determine if there are any structural problems, such as tumors, blood clots, or fistulas, which can cause chemosis, your doctor may conduct imaging tests. Imaging tests include X-rays, ultrasound, CT scans, MRIs, and angiography.

Treatment of Chemosis

The treatment of chemosis depends on the underlying cause and the severity of the swelling. Some of the possible treatments include:

  • Over-the-counter or prescription artificial tears are available to relieve the irritation and dryness caused by chemosis. Artificial tears are lubricating and moistening eye drops. As long as you follow the instructions on the label and avoid using expired or contaminated eye drops, you can use them as often as necessary.

  • In allergy-related itching, redness, and swelling caused by chemosis can be reduced by antihistamines, a medication that blocks the effects of histamine, a chemical that causes allergic reactions. Antihistamines are available as oral pills, eye drops, or nasal sprays. If you use them as directed by your doctor or pharmacist, be aware of the possible side effects, including drowsiness, dry mouth, and blurred vision.

  • An oral pill, eye drop, or injection of steroids is available to treat chemosis caused by severe allergies, infections, or autoimmune diseases. Steroids suppress the immune system and reduce inflammation. You can use them as prescribed by your doctor, but be mindful of potential risks, such as increased eye pressure, cataracts, glaucoma, or infections.

  • The purpose of antibiotics is to kill or stop the growth of bacteria. They can be used to treat chemosis caused by bacterial infections, such as conjunctivitis, orbital cellulitis, and dacryocystitis. Your doctor may prescribe oral pills, eye drops, or ointments. Make sure you follow your doctor's instructions and don't share or reuse the medication.

  • It is possible to use antivirals to treat chemosis caused by viral infections such as conjunctivitis, herpes simplex, or shingles. Antivirals are available as oral pills, eye drops, or creams. If your doctor prescribes these medications, you should be aware of possible side effects, such as nausea, headache, or rash.

  • An operation involves removing or repairing parts of the body. Chemosis can be treated with surgery if the carotid cavernous fistula, rhabdomyosarcoma of the orbit, or superior vena cava is blocked. Additionally, surgery can be used to treat chemosis that does not respond to other treatments or causes complications, such as corneal ulcers, glaucoma, or vision loss. An ophthalmologist, a doctor who specializes in eye diseases and conditions, can perform surgery to treat chemosis. The type and extent of surgery depend on the cause and severity of the condition.

Prevention of Chemosis

The prevention of chemosis depends on the underlying cause and the risk factors. Some of the possible preventive measures include:

  • Avoiding allergens: Allergens are substances that trigger allergic reactions. In addition to pollen, dust, pet dander, cosmetics, and medications, you can also prevent chemosis by avoiding or minimizing your exposure to these allergens. To improve the air quality in your home or workplace, you can use air filters, humidifiers, or dehumidifiers. Sunglasses, hats, and masks will protect your eyes from the allergens in the environment as well.

  • The practice of good hygiene involves keeping yourself and your surroundings clean. By practicing good hygiene, you can prevent chemosis as a result of infections, such as washing your hands frequently before and after touching your eyes, using clean towels and tissues, and disposing of them properly, and avoiding sharing or reusing eye makeup, contact lenses, or eye drops. Keep your nails trimmed and avoid touching or scratching your eyes, especially with dirty hands, to prevent chemosis caused by excessive rubbing.

  • Following post-operative care: Following a surgery, you receive post-operative care. Following the post-operative care instructions given by your doctor can help you prevent chemosis due to eye surgeries. This includes taking the prescribed medications, applying cold compresses or eye patches, and avoiding activities that can strain or injure your eyes, like reading, watching TV, or driving. By choosing an experienced and qualified surgeon and discussing the possible risks and benefits of the surgery before the surgery, you can also prevent chemosis from occurring.

  • An example of a chronic condition is hyperthyroidism or systemic lupus erythematosus, which can last for a long time or recur frequently. When you have chronic conditions, you can prevent chemosis by taking the prescribed medications, following the recommended diet and exercising, and monitoring your symptoms. By consulting your doctor regularly and seeking medical attention if your condition worsens or causes complications, you can also prevent chemosis caused by chronic conditions.

Conclusion

It is a condition that causes swelling of the conjunctiva, which covers the eye and the inner surface of the lids of the eyes. A variety of factors can cause chemosis, including allergies, infections, surgery, or excessive eye rubbing. The treatment of chemosis depends on the underlying cause and the severity of the swelling. Chemosis is not usually a serious problem, but it can be uncomfortable and affect your vision. If you have chemosis, you should see your doctor for a proper diagnosis and treatment. Take care of your eyes and avoid anything that can irritate or harm them.

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