Giant papillary conjunctivitis--a review

First described in 1974 by an Australian ophthalmologist Dr. Spring, Giant Papillary Conjunctivitis (GPC) is one of the external ocular allergic conditions. It is most often associated with contact lens wear, but has also been described in patients with ocular prostheses and corneal sutures following surgery. Diagnosis is usually straightforward. Patients complain of decreasing lens tolerance, mucus production, often severe enough to cause blurred vision, and some itch. Inspection will reveal conjunctival hyperaemia and enlarged tarsal papillae. Management centres around patient education regarding careful lens hygiene but in severe cases may require a change to disposable lenses or a cessation of lens wear. In some cases, pharmacological agents may be required. The histopathology of GPC is very similar to Vernal Keratoconjunctivitis (VKC). It is caused by a complex immunological reaction and is not solely IgE-mediated. Trauma and foreign body reactions also play a role. The incidence of GPC has decreased with the advent of disposable lenses.