Eye Irritation: Giant Papillary Conjunctivitis

What is giant papillary conjunctivitis (GPC)?

Conjunctivitis is inflammation of the conjunctiva. The conjunctiva is the clear membrane that lines the inside of the eyelids and covers the white of the eye. “Giant papillary” refers to large bumps that form under the eyelid. GPC is an eye irritation, not an infection.

What is the cause?

GPC can be caused by:

• an allergic reaction to the chemicals in contact lens solutions
• an allergic reaction to pollen or other allergens in the air or to deposits that can build up on contact lenses
• a contact lens or a foreign body rubbing on the inside of the upper eyelid
• a foreign body in your eye, such as a stitch from previous eye surgery

Usually allergic reactions affect both eyes. Rubbing of a contact lens or foreign body can cause irritation in only one eye.

One chemical that often causes GPC is a preservative called thimerosal. It is found in many contact lens solutions. It can remain in soft contact lenses after cleaning and disinfecting. Or it can coat the surface of gas permeable lenses. Your eyes may react to thimerosal or other chemicals at any time, even after you have used the same products for months or years.

What are the symptoms?

The symptoms may include:

• itching of your eyes or eyelids
• a gritty feeling in your eye
• redness
• sensitivity to light
• watery discharge
• changing vision
• drooping eyelids
• more movement of your contacts than usual when you blink

How is it diagnosed?

Your eye care provider will ask you what things make your symptoms worse or better. Your provider will examine your eyes and the inside of your eyelids. If you wear contact lenses, their movement on your eye will be examined. The lenses will also be examined for signs of buildup or damage.

How is it treated?

Treatment of GPC from contact lenses usually involves not wearing the lenses for several days or weeks. Your provider may suggest that you use different cleaning, wetting, or soaking solutions. You may need to change your lens-care routine to reduce the buildup of deposits on the lenses. Sometimes your lenses can be professionally cleaned to remove dirt and chemicals.

You may need to change to a different type of contacts. Your provider may recommend disposable contacts that you throw away after 1 day. If you have contacts that you throw away after wearing them for 1 week, be sure to use the enzyme cleaner recommended by your provider. If your soft contacts are irritating the inside of your eyelids, your provider may recommend that you change to gas permeable contacts. They are shaped differently and may not rub your eyelid.

If the GPC is from allergies, you will need to try to avoid things that make your symptoms worse. You may need to use eyedrops or take a medicine.

Any foreign bodies in your eyes (such as a loose stitch from previous surgery) will be removed.

How can I take care of my eyes?

Follow your provider's directions carefully. It may take some time to discover the exact cause of your GPC and then to control it.

In addition, you can:

• Use your medicines as directed.
• Keep reusable contacts clean.
• Keep all appointments for checkups.