Clinical Presentation and Management of Chemosis

Characteristic Features and Etiologies

• Chemosis presents as swelling or edema of the conjunctiva due to fluid accumulation in the subconjunctival space, appearing as a gelatinous or watery bulging of the conjunctiva that may range from mild to severe, according to the American Academy of Ophthalmology 1, 2
• Conjunctival edema with a gelatinous, watery appearance of the bulbar conjunctiva is a characteristic feature of chemosis, as noted by the American Academy of Ophthalmology 1, 2
• Viral conjunctivitis often presents with chemosis, watery discharge, and preauricular lymphadenopathy, as reported by the American Academy of Ophthalmology 1
• Allergic reactions can cause chemosis, accompanied by itching and watery discharge, according to the American Academy of Ophthalmology 1, 3
• Bacterial conjunctivitis may present with chemosis alongside purulent discharge, as noted by the American Academy of Ophthalmology 4
• Graft-versus-host disease can cause bilateral chemosis with conjunctival injection, as reported by the American Academy of Ophthalmology 5
• Thyroid eye disease is associated with chemosis, upper-eyelid laxity, and eyelid imbrication, according to the American Academy of Ophthalmology 6
• Dupilumab treatment can cause chemosis as part of dupilumab-associated ocular surface disease, as noted by the American Academy of Ophthalmology 5
• Medication-induced chemosis can occur, especially with preservatives, as reported by the American Academy of Ophthalmology 2
• Contact lens wear can lead to chemosis from mechanical irritation or hypersensitivity, according to the American Academy of Ophthalmology 3

Associated Clinical Findings

• Watery discharge suggests viral or allergic etiology, as noted by the American Academy of Ophthalmology 1
• Purulent discharge suggests bacterial infection, according to the American Academy of Ophthalmology 4
• Mucoid discharge may indicate allergic conjunctivitis, as reported by the American Academy of Ophthalmology 1
• Follicular or papillary conjunctival reaction often accompanies chemosis in infectious or allergic cases, as noted by the American Academy of Ophthalmology 1, 3
• Preauricular lymphadenopathy suggests viral etiology, according to the American Academy of Ophthalmology 1
• Eyelid edema may be present, especially in allergic or infectious cases, as reported by the American Academy of Ophthalmology 1, 2
• Acute chemosis typically resolves within days to weeks, as noted by the American Academy of Ophthalmology 1