Giant Papillary Conjunctivitis Overview

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Giant papillary conjunctivitis, commonly referred to as GPC, is a condition in which the inner lining of the eyelid (known as the palpebral conjunctiva) becomes inflamed, and develops small bumps. These small bumps—known as papillae—often form in response to some type of chronic irritation, like wearing contact lenses. In GPC, the bumps grow and combine, forming very large bumps that sometimes resemble a cobblestone appearance. People with GPC complain of redness, whitish discharge, light sensitivity, and eye itching that is worse when they remove their contact lenses.

Symptoms of Giant Papillary Conjunctivitis
Verywell / Brianna Gilmartin

Symptoms

Giant papillary conjunctivitis sometimes resembles other eye allergies in appearance. The main symptom of GPC is itchy, irritated eyes. Some people may notice an increase in symptoms during the spring and summer months.

Look out for the following signs and symptoms:

  • Itchy eyes
  • Increased mucus production
  • Desire to remove contact lenses earlier in the day
  • Gritty, foreign body sensation upon removal of contact lenses

In addition to the symptoms above, you may also notice that your contacts tend to move around a lot or don't fit as perfectly as they used to.

Causes

Giant papillary conjunctivitis is thought to be caused by certain proteins that build up on contact lenses over time. GPC can occur in people who wear soft lenses or rigid lenses, and it can come on suddenly or develop gradually.

Risk Factors

Not following proper cleaning and disinfection routines or over-wearing contact lenses can increase the risk of GPC. GPC can also be caused by the constant act of blinking over a contact lens. The eye interprets the contact lens as a foreign body and a mild type of mechanical trauma occurs. At some point, the eye's inflammatory processes kick in and the result is GPC.

People who have asthma, chronic allergies, or hay fever tend to be more prone to developing GPC.

GPC can also occur in people who wear an ocular prosthesis, or in an eye irritated by a suture from prior eye surgery.

Diagnosis

Your eye doctor will take a careful medical history and listen to your complaints. They will then observe your eyes and contact lenses under a slit lamp, a special upright microscope.

Your eye doctor will flip your upper eyelid outward so that the conjunctiva, the inner lining of the eyelid, can be easily seen (this is painless). They may also use a yellow dye to temporarily stain the surface eye tissue to aid in making a diagnosis.

Treatment

The best solution for GPC is to get rid of whatever is causing the irritation. Your eye doctor will ask you to discontinue wearing contact lenses, at least temporarily. While contact lens wearers are generally not very happy to hear this, it does speed healing.

It may only take a few weeks or as long as 6-8 months of not wearing contact lenses for the condition to completely resolve.

There are also specific treatments changes you can make to help the bumps go away and prevent recurrence:

Find a new cleaning solution

You may be asked to switch to a different disinfecting and cleaning solution. Peroxide-based cleaning solutions are slightly more complicated to use, but do a much better job of killing bacteria and viruses and removing debris that can cause irritation.

Try a new contact lens

Changing from conventional or monthly disposable contact lenses to daily disposables often helps considerably. When you wear a brand new lens every day, your lens does not have much of a chance to build up proteins that you have become allergic to.

Use prescription eye medications

Your eye doctor may prescribe steroid eye drops to lessen the inflammation. Steroids work very well for most people who have GPC. If your eye doctor prescribes topical steroid drops be sure to follow specific instructions, as steroids used in the wrong way can be harmful. Steroids can cause high pressure which causes glaucoma which can lead to vision loss.

A combination of mast cell stabilizer/antihistamine eye drop can often help considerably, and they are safe for most people to use every day.

A Word From Verywell

Proper contact lens hygiene and wearing habits are very important to lower the risk of developing giant papillary conjunctivitis. Numerous studies have shown that the frequency of lens replacement correlates closely to the development of GPC.

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3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Yeung KK. Giant papillary conjunctivitis. Medscape.

  3. Baab S, Le PH, Kinzer EE. Allergic conjunctivitis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.