Chemosis
| Chemosis | |
|---|---|
| Other names: Fluid-filled conjunctiva, swollen conjunctiva[1] | |
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| Allergic conjunctivitis resulting in chemosis | |
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| Specialty | Opthalmology |
| Symptoms | Swelling of the whites of the eye, increased tear production, itchiness, blurry vision[2] |
Chemosis is the superficial swelling of the whites of the eye or the inside of the eyelid.[2] Symptoms may vary from none to increased tear production, itchiness, and blurry vision.[2] There is generally no pain.[1] A small location or entire whites of the eye may be affected.[2] It may make it difficult to fully close the eye, which can result in exposure keratitis.[2]
It generally occurs due to allergic, viral, or bacterial conjunctivitis.[3] Other causes may include a mass behind the eye such as in thyroid eye disease or an eye injury.[2][4] The underlying mechanism involves histamine, serotonin, and bradykinin resulting in abnormal permeability of capillaries. The cornea is not involved.
Management involves addressing the underlying cause.[2] Eye lubrication may also help.[2]
The term is from the Greek words cheme and -osis, cheme meaning cockleshell, and -osis meaning condition.[5]
Signs and symptoms
Symptoms may vary from none to increased tear production, itchiness, and blurry vision.[2] A small location or entire whites of the eye may be affected.[2] It may make it difficult to fully close the eye, which can result in exposure keratitis.[2]
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An eye with a mild swollen region of the conjunctiva (front view).
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Moderate chemosis of the lower conjunctiva due to thyroid eye disease.
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Severe chemosis of the lower conjunctiva due to thyroid eye disease.
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Severe chemosis of the lower conjunctiva due to thyroid eye disease.
Causes
It is usually caused by allergies or viral infections, often worsened by excessive eye rubbing. Chemosis is also included in the Chandler Classification system of orbital infections.
Other causes of chemosis include:
- Superior vena cava obstruction, accompanied by facial oedema
- Hyperthyroidism, associated with exophthalmos, periorbital puffiness, lid retraction, and lid lag
- Cavernous sinus thrombosis, associated with infection of the paranasal sinuses, proptosis, periorbital oedema, retinal haemorrhages, papilledema, extraocular movement abnormalities, and trigeminal nerve sensory loss
- Carotid-cavernous fistula - classic triad of chemosis, pulsatile proptosis, and ocular bruit
- Cluster headache
- Trichinellosis
- Systemic lupus erythematosus (SLE)
- Angioedema
- Acute glaucoma
- Panophthalmitis
- Orbital cellulitis
- Gonorrheal conjunctivitis
- Dacryocystitis
- Spitting cobra venom to the eye
- High concentrations of phenacyl chloride in chemical mace spray
- Urticaria
- Trauma
- HSV Keratitis
- Post surgical
- Mucor
- Rhabdomyosarcoma of the orbit[6]
Diagnosis
Diagnosis is usually by examination of the affected area.
Treatment
Treatment depends on the cause. If chemosis has occurred due to excessive rubbing of the eye, the first aid to be given is a cold water wash for eyes.
References
- ↑ 1.0 1.1 "Swollen Conjunctiva". American Academy of Ophthalmology. 19 June 2012. Archived from the original on 2 October 2024. Retrieved 30 September 2024.
- ↑ 2.00 2.01 2.02 2.03 2.04 2.05 2.06 2.07 2.08 2.09 2.10 "Chemosis". Vagelos College of Physicians and Surgeons. 25 April 2022. Archived from the original on 11 July 2024. Retrieved 30 September 2024.
- ↑ "Conjunctivitis - EyeWiki". eyewiki.org. Archived from the original on 2 October 2024. Retrieved 30 September 2024.
- ↑ Leahey, Alan B. (1 May 1992). "Chemosis as a Presenting Sign of Systemic Lupus Erythematosus". Archives of Ophthalmology. 110 (5): 609. doi:10.1001/archopht.1992.01080170031011. PMID 1580831.
- ↑ "chemosis - Definition | OpenMD.com". openmd.com. Retrieved 2023-02-19.
- ↑ "Narang, G.S., Pahwa, J.S. Pediatric Oncall Child Health Care. Fungating orbital mass Question. 8 Feb 2011". Archived from the original on 2 October 2024. Retrieved 17 August 2023.
External links
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