Giant papillary conjunctivitis (GPC) is a condition where the inner surface
of the eyelids becomes irritated and inflammed. In giant papillary
conjunctivitis, large bumps (papillae), appear on the underside of the
eyelid. It is most
commonly related to wearing contact lenses. GPC occurs both in patients who
use soft and rigid gas permeable contact lenses, though it occurs much more
frequently in soft contact lens wearers. The condition can appear at
any time, even after many years of wearing contact lenses with no problems.
Rarely, people who are not contact lens
wearers can get GPC, such as people who wear artificial eyes or who have
exposed sutures (stitches) in their eye.
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 additional to
this mechanical irritation, contact lenses also trap deposits on their
surface, which add to the inflammation.
What causes GPC?
GPC is thought to be caused by one or more of the following:
- allergic reaction to the chemicals
used to dean contact lenses
- rubbing of contact lens against the
eyelid
- deposits on the lenses
If you wear contact lenses and have asthma,
hay fever or other allergies, you may be more likely to get GPC.
What are the
symptoms of GPC?
Normally, the underneath of your eyelid is very smooth. In the early
stages of GPC, this area of the eyelid becomes rough, red and swollen.
Then giant bumps (called papillae) form,
and can grow larger than 1 millimeter (about the size of a pinhead) in
diameter. Symptoms include:
- itching
- irritation
- burning
- appearance of mucous
- redness in some patients
- blurred vision (due to mucous sticking
to the contact lens)
Some people with GPC also
notice that their contact lenses tend to ride up on their eyes when they
blink, as though the lenses were sticking to their eyelid. If it is
not taken care of, GPC can damage eye tissue and the cornea (the clear front
window the eye) as the large bumps underneath the eyelid rub against the
eye. 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.
How is GPC
Treated?
GPC may be treated by:
- stopping contact lens wear for several
days or weeks to let the irritation heal and disappear
- using eye drop medicine to reduce
swelling and itchiness
- changing the type of contact lenses
you wear
- cleaning your contact lenses more
frequently with enzymes
- not using preserved lens solutions,
and switching to unpreserved salt solutions
- limiting the amount of time you wear
your lenses each day
Once GPC is under control,
some of 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
- buildup wearing time slowly
Eye drops are available that can be used for long-term
control of inflammation. These drops may even be used while contact
lenses are in the eye, though 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 an ongoing problem.
Periodic visits for examination will most likely be needed. You
should report an recurrence of symptoms as soon as possible, since
prolonged GPC is more difficult to treat.
You can ask Dr. Cano 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. One option you may wish to look into would be
LASIK,
to correct your refractive problems.
Why are regular medical eye examinations
important for everyone?
Eye disease can occur at any age. Many eye diseases
do not cause symptoms until the disease has done damage. Since most
blindness is preventable if diagnosed and treated early, regular medical
examinations by an ophthalmologist are very important. If you
are experience any optical difficulties, or just need a routine eye exam,
please make an appointment to see Dr. Cano or Dr. Manning.
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