Giant Papillary Conjunctivitis

An Overview
Giant papillary conjunctivitis (GPC) is an inflammation of the inner surface of the eyelids, most commonly related to contact lens wear. GPC is seen both in patients who use soft and rigid gas permeable contact lenses. This condition can appear at any time, even after many years of successful contact lens wear. In some unusual circumstances, GPC can occur in people who are not contact lens wearers, such as patients who wear plastic eyes.

GPC will not harm your vision but it is annoying. It is difficult to cure, and can persist despite prolonged treatment. Often the condition can be controlled so that contact lenses can be worn comfortably even if it is not cured. In some cases, however, GPC becomes a chronic problem, which can only be eliminated by discontinuing contact lens wear. GPC is not an infection, but an inflammation caused by constant blinking across a contact lens or other foreign body. Normally, the undersurface of the upper eyelid is smooth like silk. In patients with GPC, the undersurface of the eyelid is roughened and inflamed, and the entire eye becomes irritated. In addition to the mechanical irritation, contact lenses also trap deposits on their surface, which add to the inflammation.

Typical symptoms of GPC include:

• Irritation
• Redness
• Itching
• Mucus discharge
• Blurry vision

Many patients find that the symptoms are relieved once contact lens wear is discontinued, and that the symptoms return as soon as contact lens wear resumes.

GPC is treated with:

• Rest from contact lens wear, usually for several weeks
• Eye drops to control the inflammation

Once GPC is under control, the following steps may be helpful:

• Consider new contact lenses
• Use disposable contact lenses
• Change your lens care system
• Review proper lens care and storage instructions
• Limit contact lens wear
• Build up wearing time slowly

Eye drops are available that can be used for long-term control of inflammation. While these drops may be used while contact lenses are in the eye, the life of the contact lenses may be shortened. During an active episode of GPC, you will probably need to see your ophthalmologist a number of times to monitor and adjust treatment.

Finally, you must assume that GPC is a recurring problem. Periodic visits for examination will most likely be needed. You should report any recurrence of symptoms as soon as possible, since prolonged GPC is more difficult to treat.

You should ask your ophthalmologist if you have any questions about GPC or any other problems related to the health or comfort of your eyes. You should also discuss different options to correct your vision if you find that contact lenses have become a source of recurrent problems.