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What is Giant Papillary Conjunctivitis (GPC)?

Medically Reviewed by Dan Brennan, MD on May 10, 2021

Giant papillary conjunctivitis (GPC) causes swelling, redness, and irritation in the lining of the membrane inside your eyelids. Contact lens wearers have the highest risk of developing GPC. People with an artificial eye or stitches can also be vulnerable.

What Causes Giant Papillary Conjunctivitis?

GPC is a complication usually found in people who wear contact lenses. Any type of contacts can cause GPC, including soft lenses, rigid lenses, hydrogel lenses, and silicone hydrogel lenses. The first sign of the eye disorder is often feeling extra sensitivity when you close your eyes. It may feel like there’s a foreign object inside your eye. When you lift your eyelid, there are small circular lesions anywhere from .03 to 1 mm in diameter.

Pollen or other irritants in the air can build up on your lenses and cause GPC. You can also develop GPC if foreign bodies get trapped beneath your eyelids, or you have loose stitches left in your eye after surgery.

Other factors that increase your risk of GPC include:

  • Meibomian gland dysfunction
  • Poorly manufactured lens edges
  • A predisposition toward allergic diseases (atopy)
  • Allergic reaction to the contact lenses or chemicals used to clean the lenses

Taking out your contact lenses can make your symptoms more intense. That’s because lid movement increases the production of substances that affect your blood vessels, including histamines. People with GPC typically have symptoms like:

  • Swollen and droopy eyelids
  • Blurry vision because of excess mucus
  • Red and painful eyes
  • Itchiness
  • Contact lens feels like it’s moving up your eyeball after blinking

How Is Giant Papillary Conjunctivitis Diagnosed?

Eye conditions that produce symptoms similar to GPC include:

  • Seasonal allergic conjunctivitis
  • Atopic conjunctivitis
  • Viral conjunctivitis
  • Blepharitis

There are no specific lab tests available for diagnosing GPC. Some doctors recommend screening a patient’s tears for higher levels of immunoglobulin E (IgE). Physicians typically look at the size of the lesions beneath your eyelids and account for your history of wearing contact lenses. 

They also look at how the lenses move on your eyes when you blink and examine your contact lenses for damage or eye deposit buildup.

How Do You Treat Giant Papillary Conjunctivitis?

You should see a doctor immediately if your eye irritation doesn’t clear up. Untreated GPC can damage your cornea and eyelid, permanently affecting your vision.

Your doctor may ask you to remove your contact lenses for a few days or longer, giving the inside of your eyelids time to heal. Depending on the state of your eyes, your doctor may prescribe an ointment or eyedrop medicine to help with any swelling or itching. Applying cold compresses to your eyes can also provide relief from your symptoms.

Other recommendations can include changing your contact lens cleaning solution, wetting drops, or alternative lens soaking products. Changing your lens cleaning routine can cut down on the amount of build-up on your contacts. It is recommended to look for salt-based solutions versus those with preservatives. If you wear rigid contact lenses, make sure you clean them with an enzyme at least once or twice per week.

Your doctor may suggest switching to a different type of contact lens like disposables. Because they get thrown away after one day, your risk of developing GPC in the future decreases. Avoid any products containing hydrogen peroxide with these lenses.

If disposable contacts irritate your eyes, your doctor may recommend gas permeable lenses. They’re shaped differently from other contacts, making them less likely to rub against your eyelids.

Medications like a mast cell stabilizer/antihistamine ophthalmic solution can help with severe cases of GPC. You may also receive the treatment if you have a condition like keratoconus requiring you to continue wearing contacts. Your doctor may provide you with a short-term prescription for steroid eye drops. You shouldn't rely on them for longer than a few weeks because of the potential of developing eye complications like:

  • Glaucoma
  • Cataracts
  • Lower protection against eye infections

Most people can start wearing contact lenses again after receiving proper treatment.

How Can You Prevent Giant Papillary Conjunctivitis?

Start getting regular eye exams, especially if you have conditions like eczema or asthma that allergies may trigger. Avoid wearing your contact lenses for longer than recommended. If pollen played a role in your GPC, stay away from grasses and trees during the pollen season. Use the air conditioner in your home and car and keep doors and windows shut as much as possible.

Show Sources

SOURCES:

American Academy of Ophthalmology: “Giant Papillary Conjunctivitis.”

Medscape: “Giant Papillary Conjunctivitis Treatment & Management.”

The College of Optometrists: “CL-associated Papillary Conjunctivitis (CLAPC), Giant Papillary Conjunctivitis (GPC).”‌‌

Tufts Medical Center: “Eye Irritation: Giant Papillary Conjunctivitis.”

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