Giant Papillary Conjunctivitis

What is giant papillary conjunctivitis?

Giant papillary conjunctivitis (GPC) is a term for what happens when the inside of your eyelids (the conjunctiva) becomes inflamed (swollen), red and sore. Your eyelid may have bumps, called papillae.

Wearing contact lenses is a risk factor for this condition. In fact, another term for the condition is contact lens papillary conjunctivitis. It usually happens in teens and young adults.

How common is giant papillary conjunctivitis?

In the United States, there are approximately 45 million contact lens wearers. About 90% of the total number of contact lens wearers use soft contact lenses. About 5% of people who wear soft contact lenses get GPC, according to one estimate.

What are the symptoms of giant papillary conjunctivitis?

Giant papillary conjunctivitis symptoms, which usually happen in both eyes, may include:

• Red eyes.
• Itchy or sore eyes.
• An inflamed or droopy eyelid (ptosis).
• Blurred vision because of thick and possibly stringy mucus in your eyes.
• Feeling that there’s something in your eyes (foreign body sensation).

What causes giant papillary conjunctivitis?

Many causes of giant papillary conjunctivitis involve contact lenses. They include:

• Allergies to the lenses themselves or to chemicals used for cleaning or storing them.
• Friction caused by lenses rubbing against the inside of your eyelid.
• Issues with proteins, pollen, dust or other deposits left on the lenses.

Causes of giant papillary conjunctivitis that don’t involve lenses include other chronic (long-lasting) allergies or friction on the inside of your eyelids. These irritants include:

• Artificial eyes.
• Exposed stitches or scleral buckles (a piece of plastic or a sponge used to treat retinal tears).
• A filtering bleb (raised pouch) for treating glaucoma.
• A raised mineral deposit on your cornea (elevated band keratopathy).

Are there types of giant papillary conjunctivitis?

Some scientists classify giant papillary conjunctivitis into two types: primary and secondary.

Allergies are the cause of the primary type of giant papillary conjunctivitis. Repeated friction against the upper eyelids causes secondary giant papillary conjunctivitis.

Other researchers consider giant papillary conjunctivitis to have mechanical causes, making it different from allergic forms of conjunctivitis.

Is giant papillary conjunctivitis contagious?

Unlike other types of infectious conjunctivitis (pink eye), giant papillary conjunctivitis isn’t contagious.

What are the risk factors for this condition?

Risk factors for giant papillary conjunctivitis include:

• Wearing contact lenses, especially non-disposable kinds.
• Having chronic allergies.
• Having eye surgeries or treatments that may leave you with raised spots on your eyes.

What are the complications of giant papillary conjunctivitis?

Complications of giant papillary conjunctivitis include:

• Worsening of symptoms of itching, mucus and feeling like something is in your eye (foreign body sensation).
• Damage to the surface of your cornea.

Drooping eyelid, also called ptosis, or other eyelid damage.

How is giant papillary conjunctivitis diagnosed?

Your eye care specialist will ask you about your signs and symptoms and your medical history. They’ll give you a complete eye exam. They’ll flip your eyelids (evert them) to look for bumps (papillae).

In some cases, your provider may use a dye called fluorescein to make it easier to see the bumps on your eyelid.

How is giant papillary conjunctivitis treated?

If you’re a contact lens wearer, treating giant papillary conjunctivitis starts with avoiding contact lens use for at least two weeks.

Your provider may prescribe eye drops or ointments that help with itching or swelling. These topical products may be antihistamine products, mast cell stabilizer products or a combination of both.

Your provider may also recommend nonsteroidal anti-inflammatory drugs (NSAIDs) and artificial tears that don’t contain preservatives.

For severe cases, your provider may prescribe topical corticosteroids.

If you have giant papillary conjunctivitis because of an artificial eye (ocular prosthesis), you may need to refinish it or replace it.

Complications/side effects of treatment for giant papillary conjunctivitis

There are a number of side effects related to long-term use of steroid eye drops, such as cataract development and higher eye pressure.

With any type of eye drops or lotions, there’s a risk for irritation and redness.

How long does it take to recover?

You should start feeling better in about a week after you begin treatment for giant papillary conjunctivitis. It may take up to a month before you can wear contact lenses again.

Can giant papillary conjunctivitis be prevented?

There’s no way to prevent every case of giant papillary conjunctivitis. If you wear contact lenses, you may be able to do some things to lower your risk of giant papillary conjunctivitis. These things include:

• Switching to rigid gas permeable lenses or disposable soft contact lenses.
• Avoiding lens solutions that contain preservatives.
• Practicing good contact lens hygiene, which includes washing your hands before you put your lenses in or take them out, not wearing your lenses too long and not going to sleep with your lenses in your eyes.
• Using the rub and rinse method to clean your lenses because rubbing removes more deposits.

What can I expect if I have giant papillary conjunctivitis?

If you have giant papillary conjunctivitis, your outlook is good. Following the treatment plan from your provider should lead to a complete recovery.

How long does giant papillary conjunctivitis last?

Your eyes should begin to improve quickly if you follow the treatment plan from your eye care provider and continue to avoid wearing contact lenses for a few weeks.

When can I go back to work/school?

You should be able to go back to work or school immediately. You’re not contagious.

When should I see my healthcare provider?

If you find you can’t wear your contact lenses, you should see your eye care provider, especially if you have eye irritation and thick mucus.

When should I go to an emergency room?

You should always get emergency care if you have extreme eye pain or a sudden loss of vision.

What questions should I ask my healthcare provider?

You may want to ask your healthcare provider questions such as these:

• Should I change the type of contact lenses I wear?
• Should I stop wearing contact lenses at all?
• Do I need to have a new artificial eye made?
• What’s the treatment for giant papillary conjunctivitis?
• What are the side effects related to this treatment?

A note from Cleveland Clinic

If you wear contact lenses or have an artificial eye, you may develop a form of noninfectious conjunctivitis called giant papillary conjunctivitis. This condition is very manageable. Make sure you see your eye care provider. Ignoring this condition could lead to more serious damage to your eye, especially your cornea.