GIANT PAPILLARY CONJUNCTIVITIS

 Most often associated with wearing contact lens

(especially soft lens)

 Mechanisms:
o Irritation and friction from the lens damages conjunctival
epithelial cells  inflammation
o Proteinaceous deposits on lens surface  possible
allergic reaction (infiltration of neutrophils, lymphocytes,
mast cells and plasma cells, elevation of cytokines and
chemokines in tear (but not histamines), increased
production of tear immunoglobulins)

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GIANT PAPILLARY CONJUNCTIVITIS
 Stages:
o 1: minimal mucus discharge upon wakening, occasional
itching, tarsal conjunctiva normal/ mild hyperemia
o 2: increased symptoms, mild-moderate injection of
conjunctiva, some loss of normal vasculature pattern,
papillary reaction variable in size
o 3: marked thickening and injection of tarsal conjunctiva,
obscuration of normal vascular pattern, papillae increase
insize and number
o 4: CLs intolerance, eyelids stuck together in the morning,
large papillae, +- subconjunctival scarring and fluorescein
staining of the apices of the papillae
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GIANT PAPILLARY CONJUNCTIVITIS

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GIANT PAPILLARY CONJUNCTIVITIS
 Treatment:
o Decrease wear time, changing material/design of lens,
shortening replacement interval
o Artificial tears
o Mast cell stabilizers (continued use once return to CLs wear)
o Topical NSAIDS, topical steroids (chronic treatment with
steroid is not recommended)