“Contact lens giant papillary conjunctivitis.”
Now that is a mouthful. When I tell patients they have this condition, the ensuing facial expressions looks like I might have delivered a death sentence, because the name sounds so ominous.
Contact lens-associated giant papillary conjunctivitis (or GPC) is not an uncommon condition, and it seems to increase in prevalence in association with the spring and summer allergy season.
We take for granted that a contact lens is a foreign object sitting on the eye for 12-plus hours a day. The biggest inciting factor for GPC is the mechanical component of the contact lens rubbing against the inside of the eyelid with every blink.
The hardest thing for patients to understand is that symptoms might start after 20 years of blissful, uncomplicated contact lens wear. The eye starts to build an inflammatory response to the contact lens and the deposits that build up on the lens.
The reason for the “giant” adjective in this condition’s name is that there are large papillae (or inflammatory bumps) on the inside of the upper eyelid. The patients start to have discomfort with their contact lens, excessive movement of their lenses, blurred vision with their lenses, and often some discharge as well.
The trickiest part for us is that the best treatment is to stop contact lens wear. Many patients who rely on contacts are probably cringing just reading that. Most contact lens wearers love the luxury of being glasses free.
There are other treatment options available too, but sometimes getting rid of GPC can be a real battle in patients who wish to continue contact lens wear.
Our first step is to switch to a better cleaning system for the lenses. The hydrogen peroxide cleaners are preservative free and get a better clean on the lens to eliminate more deposits.
We also treat acute cases with some form of allergy or steroid eye drops.
Lastly, we try to put patients in daily disposable lenses. They get a fresh lens every day, will have no deposits rubbing the eyelid, and the lenses tend to be slightly thinner, which also results in less eyelid irritation.
GPC often is a recurrent, nagging condition. Some patients ultimately discontinue contact lenses altogether. The best preventative measures are not over-wearing or abusing your contact lenses, cleaning with peroxide-based solutions, and going into a daily disposable modality.
As with any contact lens irritation, it is always best to discontinue lens wear until you see your eye care provider to evaluate the cause.
Caroline Bundrick, O.D. is an optometrist practicing at Darling Eye Center, with offices in Bluffton and on Hilton Head Island.
