Giant Papillary Conjunctivitis Overview

Giant papillary conjunctivitis, commonly referred to as GPC, is a condition in which the inner lining of the eyelid (known as the palpebral conjunctiva) becomes inflamed and develops small bumps. These small bumps—known as papillae—often form in response to wearing contact lenses or other chronic irritation.

In GPC, the bumps grow and combine, forming very large bumps that sometimes resemble a cobblestone appearance. Giant papillary conjunctivitis symptoms include red eyes, whitish discharge, light sensitivity, and eye itching that is worse when you remove contact lenses.

This article presents GPC symptoms and common causes of giant papillary conjunctivitis. It explains how GPC is diagnosed and treated, as well as steps you can try to prevent it.

Papillary Conjunctivitis Symptoms

Giant papillary conjunctivitis sometimes resembles other eye allergies in appearance. The main symptom of GPC is itchy, irritated eyes. Some people may notice an increase in symptoms during the spring and summer months.

In addition to the symptoms above, you may also notice that your contacts tend to move around a lot or don't fit as perfectly as they used to.

Causes of Giant Papillary Conjunctivitis

Giant papillary conjunctivitis is thought to be caused by certain proteins that build up on contact lenses over time. GPC can occur in people who wear soft lenses or rigid lenses, and it can come on suddenly or develop gradually, though it's less common with rigid lens use.

Risk Factors

Not following proper cleaning and disinfection routines or over-wearing contact lenses can increase the risk of GPC.

GPC can also be caused by the constant act of blinking over a contact lens. The eye interprets the contact lens as a foreign body and a mild type of mechanical trauma occurs. At some point, the eye's inflammatory processes kick in and the result is GPC.

Conditions that can lead to greater risk of giant papillary conjunctivitis:

• Asthma
• Chronic allergies
• Hay fever
  

GPC can also occur in people who wear an ocular prosthesis (glass eye) or in an eye irritated by a suture from prior eye surgery.

Diagnosing Papillary Conjunctivitis

Your eye doctor will take a careful medical history and listen to your complaints. They will then observe your eyes and contact lenses under a slit lamp, a special upright microscope.

Your eye doctor will flip your upper eyelid outward so that the conjunctiva, the inner lining of the eyelid, can be easily seen (this is painless). They may also use a yellow dye to temporarily stain the surface eye tissue to aid in making a diagnosis.

Papillary Conjunctivitis Treatment

The best solution for GPC is to get rid of whatever is causing the irritation. Your eye doctor will ask you to discontinue wearing contact lenses, at least temporarily. While contact lens wearers are generally not very happy to hear this, it does speed healing.

Your eye doctor may prescribe steroid eye drops to lessen the inflammation. Steroids work very well for most people who have GPC. If your eye doctor prescribes topical steroid drops, be sure to follow specific instructions. Note that steroids can cause high pressure which can lead to glaucoma and vision loss.

Preventing Giant Papillary Conjunctiva

There are specific changes you can make to help the bumps go away and prevent recurrence.

Find a New Cleaning Solution

You may be asked to switch to a different disinfecting and cleaning solution. Peroxide-based cleaning solutions are slightly more complicated to use, but do a much better job of killing bacteria and viruses and removing debris that can cause irritation.

Try a New Contact Lens

Changing from conventional or monthly disposable contact lenses to daily disposables often helps considerably. When you wear a brand new lens every day, your lens does not have much of a chance to build up proteins that you have become allergic to.

Use Eye Drops

A combination of mast cell stabilizer/antihistamine eye drop can often help considerably, and they are safe for most people to use every day.

Summary

Giant papillary conjunctivitis occurs due to inflammation of the inner eyelid. The small bumps and other symptoms of GPC typically occur due to contact lens use. An eye doctor can diagnose and treat GPC, while offering advice on prevention.

Proper contact lens hygiene and wearing habits are very important to lower the risk of developing giant papillary conjunctivitis. Numerous studies have shown that the frequency of lens replacement correlates closely to the development of GPC.