Prevalence of conjunctival changes in wearers of hard contact lenses

The prevalence of elevated papillae more than 0.3 mm in diameter was 10.5% in the conjunctivae of 200 subjects who had successfully worn polymethylmethacrylate hard contact lenses for eight hours or more daily for more than five years. Only three of 500 (0.6%) control subjects who had never worn contact lenses had these papillary changes. The prevalence of papillary changes for those with the so-called normal symptoms of mucus, itching, or both associated with wearing of hard contact lenses was 53% (16 of 21 subjects). The prevalence of these symptoms was 76% among subjects with polymethylmethacrylate contact lenses who had papillary changes and 8% among subjects with polymethylmethacrylate contact lenses who did not have papillary changes. We conclude that changes in the upper tarsal conjunctiva are associated with the wearing of hard contact lenses, occur in a significant percentage of patients wearing hard contact lenses for prolonged periods, and include a spectrum of papillary changes.