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GIANT PAPILLARY CONJUNCTIVITIS
What is Giant Papillary Conjunctivitis?
Conjunctivitis is an inflammation of the conjunctiva---the clear mucous membrane lining the eyelids and the white structures of the eye. Giant papillary conjunctivitis, also known as GPC, is a condition of the conjunctiva in which lid structures known as papillae become very large. In most cases, the enlargement of papillae is accompanied by itching and mucous discharge.
What Causes GPC?
GPC is most commonly associated with wearing contact lenses ESPECIALLY OVERWEARING CONTACT LENSES. Having first become a major concern of eyecare professionals in the 1970's, it is considered a relatively "new" eye condition. In addition to contact lens wear, GPC may result from another foreign object on the eye's surface such as an exposed suture from previous surgery.
What are the Symptoms of GPC?
In the mild stage, discomfort with normal contact lens wearing time is the most common symptom. Many factors can affect comfortable wearing time, such as lack of sleep, environmental irritants, or dry eyes. However, persistent loss of wearing time, in the absence of identifiable reasons, may indicate an early stage of giant papillary conjunctivitis.
GPC is a Major Disappointment to Many Contact Wearers.
Giant papillary conjunctivitis can be a disappointing, discouraging condition since it is primarily caused by long-term use of contact lenses. Some contact lens wearers who have enjoyed lenses for many years become intolerant and must return to glasses. Preventive measure for those who wear contact lenses should include good care of your lenses, with cleaning, disinfecting and soaking with solutions recommended by Dr. Fife. Generic and sale brands are not recommended, and neither is switching solutions between many different care systems. Stick to the solutions and care system recommended in our office. Routine measures should be taken such as daily cleaning with a surface rub of at least 15 seconds with either your cleaning or disinfection solution. Occasionally a weekly cleaning with enzymatic protein deposit remover will be added to the cleaning regimen.
What Treatment Options Are Available?
Giant papillary conjunctivitis is quite difficult to treat. Discontinuing lens wear is usually required to treat patients that are in stage 3 or 4 of the disease. Decreased wearing time, more frequent lens replacement, or diligent cleaning may be all that is needed in stage 1 disease. The most effective, easiest treatment of giant papillary conjunctivitis is simply to discontinue contact lens wear. Of course, many contact lens wearers find this an unacceptable solution. If the eyes are given an opportunity to recover, contact lens wear may be possible at a later time. However, even after a break, the problem may recur when lens wear is resumed. Working with Dr. Fife, alternatives can be explored such as a change in the type of lens worn. Simply replacing the lenses on a more frequent schedule is often helpful. Disposable lenses with shorter replacement intervals may be a good option for those who experience problems.
GPC is Easier to Prevent than Cure.
Even though we do not know exactly what causes giant papillary conjunctivitis, we do know that protein levels are likely a contributing factor and protein deposits build up and are more difficult to remove the longer the contact lenses are worn. This means that replacing contact lenses at their scheduled replacement and meticulous attention to cleaning is important.
Giant papillary conjunctivitis is treatable and there are many options to explore before "giving up" on your contact lenses. Working together, you and Dr. Fife can explore alternatives for care and develop a plan for continued clear and comfortable vision.