Giant papillary conjunctivitis. Sounds scary right? Many contact lens wearers actually suffer from this condition without even knowing it. But don’t fret – giant papillary conjunctivitis, or GPC, is not some incurable, life-threatening disease. It is a type of allergic inflammation of the conjunctiva that is actually easily prevented and treated.
The conjunctiva is the thin layer of transparent tissue that lines the inner surface of the eyelids and covers the sclera, or the white part of the eye. The chronic presence of a foreign body in the eye causes constant friction against the conjunctiva that leads to GPC. As you can imagine, soft and hard contact lenses in particular continuously rub against the inner surface of the eyelid, especially when you blink. Thus GPC has been called contact lens-induced papillary conjunctivitis, or CLPC, as well. However, GPC can also be caused by an exposed suture on the surface of the eye following surgery or even a prosthetic eye due to the mechanical microtrauma caused to the eyelid.
The most distinguishing characteristic of GPC is the development of small bumps on the inner surface of the eyelid. When your optometrist flips your lid, they are not doing this to make you look funny; they are checking the underside of your eyelids for these bumps that are not visible when the eyelid is in its normal position. Without proper treatment, these bumps can grow and combine to resemble a cobblestone appearance. As a result of these bumps rubbing against the eye, you can experience red, itchy eyes similar to the discomfort experienced from other allergies. In severe cases, there may be a mucous discharge, sensitivity to light, and even swollen eyelids. Contact lenses may also move around a lot when you blink, which can be quite irritating and cause blurred vision.
GPC is more common in people who do not properly clean or replace their contact lenses. Protein deposits that build up on the lenses from extended wear can increase the severity of inflammation of the conjunctiva. Not only does poor care of contact lenses lead to GPC, but it can also lead to bacterial infections that affect the eyes, which can complicate the treatment of GPC. Contact lens wearers who also suffer from other allergies, whether it be seasonal allergies or allergies to animals, can be more prone to GPC. The irritation associated with these allergies can have an additive effect to the inflammation from friction caused contact lenses. People who have had surgery to treats the cornea of the eye or wear a prosthetic eye can also experience inflammation from foreign objects rubbing against the conjunctiva.
Luckily, GPC can easily be avoided by replacing your contact lenses frequently and not wearing them past their recommended wear time. However, if you do experience the symptoms associated with GPC, a simple visit to your optometrist can help alleviate your discomfort. If you’ve ever wondered why your optometrist flips your upper eyelid, it is to check for any irritation or inflammation on the underside of the lid. For most cases, temporarily stopping the use of your contact lenses will allow the symptoms to gradually disappear over time. It is also important to not rub your eyes to prevent further irritation. If it is the specific brand or type of contact lens that is causing GPC, your optometrist can switch you to a different contact lens that is more appropriate for your eyes. Switching to daily disposable contact lenses in particular can help prevent protein buildup that results from extended wear. Also, a more effective cleaning solution such as a hydrogen peroxide based solution may be recommended as well. For those people who also suffer from other allergies, antihistamines may also provide some relief. Fortunately, 80% of patients can return to normal contact lens wear following proper treatment.
If you do not seek proper treatment for GPC from your optometrist, you are at risk of developing temporary or even permanent contact lens intolerance. If you can no longer wear contact lenses without experiencing the symptoms associated with GPC, you may only be able to wear glasses to prevent further damage to your eyes. For many contact lens wearers, this is an unacceptable solution, so it is important to properly care for your contact lenses to ensure this does not happen. Moreover, ptosis, or drooping, of the upper lids can also occur, requiring surgery if there is interference with normal vision.
Evidently, the best solution to treating GPC is preventing it from occurring in the first place! We highly recommend that you properly clean and frequently replace your contact lenses to avoid any irritation and damage to your eyes. Yearly comprehensive eye exams and contact lens follow-ups with your optometrist can ensure that your eyes and conjunctiva are healthy and providing you with the best vision possible.
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