Giant Papillary Conjunctivitis: Symptoms, Causes, and Treatment

Giant papillary conjunctivitis is a painful eye condition that causes large red bumps to appear on the inside of your eyelids. It primarily affects people who wear contact lenses.

Seasonal allergies or an allergy to materials in contact lenses aggravate the condition.

Eye care professionals treat giant papillary conjunctivitis with medicated eye drops. 

What is Giant Papillary Conjunctivitis?

Giant papillary conjunctivitis is a rare type of eye inflammation caused by allergens or chronic trauma. It affects 1 out of every 100 contact-lens wearers. People who do not wear contacts can (and sometimes do) develop the condition, but it is uncommon. 

You may also need to stop wearing your contacts for a while to help your eyes heal. Once the condition is under control, switching the brand of contact lenses you use can keep it from coming back. 

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Types and Stages

There are two main types of giant papillary conjunctivitis. They have different causes:

• Primary giant papillary conjunctivitis is caused by exposure to allergens. 
• Secondary giant papillary conjunctivitis is caused by exposure to irritants.

Progression

As giant papillary conjunctivitis progresses, its symptoms become more pronounced.

At first:

• Your eyes become slightly irritated and uncomfortable. You may experience mild eye pain or itchiness. 
• Your eyes may become slightly red and watery.
• You may notice small amounts of mucus being discharged from your eyes. 

In advanced stages:

• Contact lenses become so uncomfortable that they are nearly impossible to wear.
• Your vision may become blurry due to tears or extreme irritation.
• There may be large, painful bumps on the inside of your eyelids. 

You may notice visible whitish residue on your contact lenses when you remove them. 

Symptoms

Symptoms of giant papillary conjunctivitis include:

• Red eyes
• Itchy eyes
• Eye pain
• Mucus discharge from the eyes
• Painful bumps on the inside of the eyelid
• Blurry vision

Symptoms usually grow more severe the longer the condition remains untreated. 

Causes 

Causes of giant papillary conjunctivitis include:

• Allergies to either your contact lenses or the cleaners you use
• A foreign body (such as a contact lens or artificial eye) rubbing against the inside of your eyelid
• Protein or other contaminants on your contact lenses
• Chronic allergies that affect your eyes

In many cases, multiple factors contribute to the condition. 

Risk Factors

Among the factors that put you at greater risk of developing giant papillary conjunctivitis are:

• How long you wear your contacts
• Your contact lens hygiene
• Your history of allergies, especially those that affect the eyes
• Seasonal changes, especially the onset of spring or fall

Treatment

Eye doctors treat giant papillary conjunctivitis with medicated eye drops. Depending on your needs, these eye drops may contain:

• Mast cell stabilizers like lodoxamide or cromoglicate
• Antihistamines
• Steroids

Most courses of treatment last two to four weeks.

Because giant papillary conjunctivitis has so many potential causes, treatment may involve some trial and error. If your first course of treatment is not successful, your eye doctor may switch to a different approach. Surgery is among the treatment options for advanced and persistent cases. 

Eye doctors sometimes recommend not wearing your contact lenses until your eyes heal. If this is not possible, they may suggest that you minimize the amount of time you spend wearing them each day. 

If you continue to wear your contacts during the healing process, rinse your eyes with saline several times a day. This will reduce inflammation and pain and promote faster healing. 

Complications

Giant papillary conjunctivitis does not usually lead to major complications. But if the condition is severe, it may make it difficult for you to see properly. It may also make you reluctant to wear your contact lenses, significantly reducing your quality of life. 

For these reasons, it is important to treat giant papillary conjunctivitis quickly. Follow your eye doctor’s recommendations to ensure that the condition heals as soon as possible and does not come back. 

Prevention

To prevent giant papillary conjunctivitis:

• Do not wear your contacts for more than one day at a time. Remove them when you go to bed each night. 
• Improve your contact lens hygiene. Each time you remove your lenses, clean them with a hydrogen peroxide solution. Once a week, clean them with a proteolytic enzyme to remove protein build-up. Store them in a sealed container of fresh saline when not in use. 
• Switch contact brands. If your contacts are irritating your eyes, do not continue to use them. Instead, look for contacts made with a different design, different materials or a lower water content. 

FAQs

Does giant papillary conjunctivitis go away?

Giant papillary conjunctivitis does go away with treatment, but it will not usually go away on its own. See your eye doctor as soon as possible if you are experiencing symptoms of this condition.

What causes giant papillary conjunctivitis?

Giant papillary conjunctivitis is usually caused by irritation from contact lenses. It may also be caused by seasonal allergies or protein buildup on your contact lenses.

How do you treat giant papillary conjunctivitis? 

Giant papillary conjunctivitis is treated with medicated eye drops. You may also need to stop wearing your contacts for a while to help your eyes heal. Once the condition goes away, you can help prevent it from recurring by switching the brand of contact lenses you use. 

References

1. Eye Irritation: Giant Papillary Conjunctivitis. (2022). Tufts Medical Centre: Community Care.

2. Conjunctivitis. (2022). Hospital of St. John’s and St. Elizabeth.

3. CL-associated Papillary Conjunctivitis (CLAPC), Giant Papillary Conjunctivitis (GPC). (2022). The College of Optometrists.

4. Giant Papillary Conjunctivitis. (2022). Columbia University Department of Ophthalmology.

5. Giant Papillary Conjunctivitis: Care Instructions. (August 2020). MyHealth Alberta.

6. Contact Lens Chemistry and Giant Papillary Conjunctivitis. (January 2003). Eye & Contact Lens: Science & Clinical Practice.

7. Rethinking GPC: A New Look at an Old Problem. (March 2015). Review of Cornea & Contact Lenses.

8. Risk Factors for Contact Lens Induced Papillary Conjunctivitis Associated with Silicone Hydrogel Contact Lens Wear. (May 2014). Eye & Contact Lens.

9. 16 – Giant Papillary Conjunctivitis. (2013). Ocular Surface Disease: Cornea, Conjunctiva and Tear Film.

10. Treatment of Giant Papillary Conjunctivitis. (1991). Considerations in Contact Lens Use Under Adverse Conditions: Proceedings of a Symposium.