1. Acquired blockage of orbital lymphatics following orbital surgery (lateral orbitotomy) or because of erysipelas or lymphogranuloma venereum
*2. Chronic hereditary lymphedema (Nonne-Milroy-Meige disease)
*3. Drugs, including the following:
 

acetohexamide acetophenazine acetyldigitoxin actinomycin C adrenal cortex injection albuterol aldosterone allobarbital amantadine aminopterin aminosalicylate aminosalicylic acid amobarbital amodiaquine amphotericin B and compounds antimony lithium thiomalate antimony potassium tartrate antimony sodium tartrate antimony sodium thioglycollate antipyrine aprobarbital aspirin auranofin aurothioglucose aurothioglycanide barbital benoxinate benzalkonium benzathine penicillin G betamethasone bleomycin brinzolamide bupivacaine butabarbital butacaine butalbital butallylonal butaperazine butethal cactinomycin captopril carbachol carbamazepine carbenicillin carphenazine cefaclor cefadroxil cefamandole cefazolin cefonicid cefoperazone ceforanide cefotaxime cefotetan cefoxitin cefsulodin ceftazidime ceftizoxime ceftriaxone cefuroxime cephalexin cephaloglycin cephaloridine cephalothin cephapirin cephradine chloral hydrate chlorambucil chloramphenicol chlorhexidine chlorisondamine chloroprocaine chloroquine chlorpromazine chlorpropamide chlortetracycline chrysarobin cisplatin clofibrate clomipramine cloxacillin cocame colistin colloidal silver cortisone cyclobarbital cyclopentobarbital cyproheptadine dactinomycin danazol dapsone daunorubicin

demecarium demeclocycline desipramine deslanoside desoxycorticosterone dexamethasone dextrothyroxine diacetylmorphine diatrizoate meglumine and dibucaine dicloxacillin diethazine diethylcarbamazine digitoxin dionin dorzolamide doxepin doxorubicin doxycycline dromostanolone dyclonine echothiophate emetine enalapril epinephrine ergonovine ergotamine erythromycin ethopropazine etidocaine etretinate F3T floxuridine fludrocortisone fluorouracil fluoxymesterone fluphenazine fluprednisolone gitalin glyburide gold Au 198 gold sodium thiomalate griseofulvin heptabarbital hetacillin hexachlorophene hexamethonium hexethal hexobarbital hydrabamine penicillin hydralazine hydrocortisone hydroxychloroquine ibuprofen idoxuridine IDU imipramine iodide and iodine solutions iron dextran isoflurophate isosorbide isotretinoin ketoprofen lanatoside C levodopa levothyroxine lidocaine lithium carbonate mannitol maprotiline mecamylamine medrysone melphalan mephobarbital mepivacaine meprednisone mercuric oxide mesoridazine metharbital methdilazine methitural methohexital methotrimeprazine methyldopa methylergonovine methylpentynol methylprednisolone methysergide metoclopramide metrizamide metronidazole mianserin mild silver protein

minocycline mitomycin moxalactam nafcillin naproxen neomycin nitromersol nortriptyline oral contraceptives ouabain oxacillin oxprenolol oxyphenbutazone oxytetracycline paramethasone pentobarbital pentolinium perazine pericyazine perphenazine phenacaine phenazine phenobarbital phenylbutazone phenylephrine pilocarpine piperacetazine piperazine piperocaine pipobroman poliovirus vaccine polynoxylin B potassium penicillin G potassium penicillin V potassium phenethicillin practolol prazosin prednisolone prednisone prilocaine primidone probarbital procaine procaine penicillin G prochlorperazine promazine promethazine propiomazine propoxycaine protriptyline quinacrine radioactive iodides rifampin rubella virus vaccine (live) sanguinarine secobarbital silicone silver nitrate silver protein sodium sodium antimonylgluconate sodium salicylate stibocaptate stibophen streptomycin succinylcholine sulindac suramin talbutal testolactone testosterone tetracaine tetracycline tetraethylammonium thiamylal thiethylperazine thimerosal thiopental thiopropazate thioproperazine thioridazine thiotepa thyroid tolazamide tolbutamide triamcinolone trifluoperazine triflupromazine trimeprazine trimethaphan trimethidinium urokinase vidarabine vinbarbital vinblastine

4. Glandular fever
5. Hypersensitivity-local topical allergies
*6. Increased bulk of orbital contents-orbital tumors, cysts, or endocrine exophthalmos
7. Local inflammatory conditions

 *A. Cerebral cavity-acute meningitis
 *B. Eye-viral conjunctivitis, corneal ulcer, fulminating iritis, or panophthalmitis
 C. Lacrimal passages-dacryocystitis
 D. Lids-styes, vaccinia, acute meibomitis, insect bites, or vaccinal pocks
 E. Nasal cavity-sinusitis
 *F. Orbit-cellulitis, periostitis, dacryoadenitis, tenonitis

8. Myxedema-infiltration with mucopolysaccharides
9. Reduced plasma protein level-nephrotic state
10. Systemic lupus erythematosus
*11. Vasomotor instability-angioneurotic edema or premenstrual phase of water retention
12. Venous congestion-local obstruction of orbital apex, carotid-cavernous fistula, thrombosis of cavernous sinus, or right-sided heart failure
13. Whipple disease

Disdier P. et al. Chemosis associated with Whipple's disease. Am J Ophthalmol 1991; 112:217-219.

Fraunfelder FT, Fraunfelder FW. Drug-induced ocular side effects. Woburn, MA: Butterworth-Heinemann, 2001.

Leahey AB, et al. Chemosis as a presenting sign of systemic lupus erythematosus. Arch Ophthalmol 1992; 110: 609-610.