An immunological study of papillary conjunctivitis due to contact lenses

Serum and tear levels of IgE were compared in patients with contact lens papillary conjunctivitis (CLPC), vernal keratoconjunctivitis (VC), healthy contact lens wearers (CLW), and healthy controls without lenses. The mean of serum IgE was elevated only in the VC group. Tear IgE levels were significantly higher for CLPC and VC than for CLW and healthy controls. Tear IgG levels were also increased in CLPC patients. With serum albumin (HSA) as a marker for leakage of proteins from the circulation to the tear fluid, the data indicated, that tear IgG was blood-borne whereas tear IgE was essentially a product of local synthesis. In one of the 10 CLPC patients, high titers of IgE type antibodies to housedust mites and cat epithelium were demonstrated in both serum and tears. We conclude that CLPC is usually an IgE mediated reaction to the lens material or to contaminations of allergenic material that sticks to the lenses.