What treatment would you recommend for chemosis?

Question

I recently got diagnosed with chemosis of the conjunctivita and was wondering how I can treat it at home to sleep and got about my day with minimal problems

Mehryar (Ray) Taban, MD, FACS · Answer

The answer depends on the cause of chemosis and how long you had it.  See my link on chemosis. Discuss with your surgeon or ophthalmologist.

Chris Moss, MBBS, FRACS · Answer

Post-operative Chemosis is swelling and inflammation of the conjunctiva after eyelid surgery. Just like the eyelids swell after eyelid surgery, the conjunctiva can also swell. The conjunctiva is the clear membrane that coats your eye’s outer surface. Most of the time chemosis occurs in a small area on the outside corner of the sclera (the white part of your eye).

Treatment: The simplest and initial approach to resolving chemosis is management of any dryness of the eyes. 
- Artificial tears (liquid or gel drops) should be used at least every hour during the day. Use whatever drops give you the best eye comfort levels.
- At night, the eye should be covered with a bland ophthalmic ointment (eg. Lacrilube), or (if prescribed) medicated Hycor steroid ointment.
- Medicated drops that reduce inflammation can be commenced during the day.  
- If dryness or chemosis persist you will need review without delay.

Richard J. Bruneteau, MD · Answer

Chemosis is a severe form of swelling that occasionally occurs following blepharoplasty surgery. This swelling typically involves the conjunctiva and sclera. It has the appearance of blistering with associated pinkish discoloration.In most cases, it resolves in one to two weeks following surgery. It tends to respond nicely to iced compresses and steroid drops. In some cases, procedures designed to drain and decompress the conjunctiva may be necessary. It's essential to avoid drying of the conjunctiva and sclera. For this reason, tarsorrhaphy procedures and eye patches are occasionally utilized as well.When this situation arises, it's important to contact your plastic surgeon as soon as possible. Your surgeon should be able to outline a treatment plan that results in resolution of this problem.

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for the question. Chemosis is the swelling of the conjunctiva (the mucous covering of the eye.) It occurs on occasion with lower eyelid surgery. Treatments often tried are cold compresses, chilled artificial tears and steroid eye drops. If those treatments are not effective then a small incision into the conjunctiva might be helpful. It usually resolves within a few months.

Earl Stephenson, Jr., MD, DDS, MBA · Answer

There are many ways to treat chemosis. The simplest way is topical steroid drops for short duration of time. Another effective ways to ask "drain the chemosis" by making a little incision into the conjunctiva to help reduce the swelling. Another way that is a little bit more daunting, it would be to actually suture the outer edge of the upper and lower eyelids together to cover the chemosis to allow it to resolve. Speak with your surgeon concerning the best ways to your chemosis.

Kenneth D. Steinsapir, MD · Answer

Chemosis is swelling of the conjunctiva, the white covering that protects the eye.  This tissue lines the eyelids and covers the eye to the cornea.  Like other tissue in the body, inflammation caused it to swell and this swelling is called chemosis.  Two factors seem to influence chemosis: 1) the disruption of lymphatics associated with eyelid surgery and 2) conjunctival drying.  It is possible to get into a cycle where the chemosis is exposed between the eyelids and this drying causes the chemosis to persist.  Very aggressive canthal tightening and upper and lower eyelid surgery incisions that are set close together also contribute to conjunctival swelling.  However, the number one factor that can benefit from treatment is conjunctival drying.  I recommend avoiding the steroid antibiotic combination medications because the antibiotic portion of these products can be very irritating and rather than helping they actually worsen conjunctival swelling.Rather than seeing a general ophthalmologist, I would recommend consulting a fellowship trained oculoplastic surgeon.  This is a board certified ophthalmologist who has completed a fellowship approved by the American Society for Ophthalmic Plastic and Reconstructive Surgery (ASOPRS).  These surgeons are among the most extensive trained in eyelid surgery and have a great deal of direct experiencing managing chemosis.  They have the training, equipment, and experience needed to diagnosis and manage this complication.  ASOPRS maintains a directory on their website that will help you find a well qualified oculoplastic surgeon in your area who can help you (ASOPRS dot org).

Michael I. Echavez, MD · Answer

If you have not already, you should be examined by an eye doctor (ophthalmologist) to determine if you have chemosis and what might be the cause.  If you do have chemosis, there are medications that can be prescribed to help with this problem.

William Portuese, MD · Answer

It is important to know why you're having chemosis, and  cause will dictate what the treatment would be for this.   In our practice, we occasionally see it from lower eyelid surgery, and industry steroid eye drops and eye ointment

Steven Wallach, MD · Answer

Chemosis is swelling of the conjunctiva often related to surgery. If it was very recent, treatment is often eyedrops, ointment, anti-inflammatories like a steroid, and even patching the eye. It really depends.  Good luck.

Sean Freeman, MD · Answer

Kennethbevis101, should it be prolonged after surgery I would suggest you see an ophthalmologist and get treatment options reviewed. Make sure you keep your surgeon in the loop. Good luck!

What treatment would you recommend for chemosis?

Answers (12)

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