If you’ve worn contact lenses for years and your eyes have become itchy, irritated or feel like there’s something stuck under your eyelid, chances are you could have giant papillary conjunctivitis – also known as GPC.
What causes GPC?
GPC is a form of allergic conjunctivitis. In this case, the allergic reaction is to the mechanical rubbing of the underside of your eyelid against your contact lens.
This condition used to be more common 20 years ago. This was for a number of reasons. Back then, most contact lenses were replaced monthly, rather than daily (as they usually are today). Lens designs and materials have also improved. The edges of the lens are more streamlined and the surface less likely to become dirty.
But GPC still exists. Here at The Eye Practice we see a case every month or two – usually in patients who are new to our practice. Most cases involve soft lenses that are replaced two-weekly, combined a preserved multipurpose (all-in-one) solution. This is a recipe for contact lens failure.
SIGNS and SYMPTOMS
- GPC usually comes on as a gradual irritation building up over a couple of weeks.
- You may have a foreign body sensation in the eyes (feeling like there's something in them).
- The eyes can be itchy, making you feel like rubbing them.
- There may be a stringy, mucous discharge produced, which collects in the corners of your eyes.
The clinical signs of GPC can be seen by an optometrist, using a slit-lamp bio-microscope.
- They will invert your eyelids (look under them) and if you have GPC.
- They will see the classic cobble-stone effect of red lumps (papillae) as in the image above.
- Papillae are common in allergic reactions, but these are much bigger than usual, which is why the condition acquired its name of GIANT papillary conjunctivitis.
How can I get rid of GPC?
- First, remove your contact lenses and wear glasses until the condition is resolved.
- Next, see your therapeutically-endorsed optometrist. They will examine your eyes and confirm your diagnosis.
- Ýour optometrist may prescribe anti-inflammatory or anti-allergy eye drops to relieve your symptoms and clear up this condition. These drops may be prescription steroids (such as FML), prescription anti-allergy (such as Patanol) or over-the-counter anti-allergy (such as Zaditen). All of these work in different ways to calm down the under-side of the eyelid.
- You will need to have a follow up with your optometrist after 2-3 weeks. If the condition is clearing up as expected, they can refit you with a more appropriate contact lens. You may need to continue on the medicated eye drops throughout this time.
- Your optometrist will discuss cleaning solutions for your new lenses (unless they are daily disposable and require no cleaning).
Tips for managing GPC
If at all possible, change to daily disposable lenses. These have the double advantage of avoiding not only contact lens solutions but also deposits building up on the lens – both of which can be implicated in GPC
If you have to use a non-daily disposable lens, look at frequent replacement. Monthly lenses may be available in your prescription. If not, some suppliers will provide a special offer or discount on frequently replaced lenses.
Change the design of your lens. Get your contact lens expert to refit you with a modern design, with a contoured edge profile and a non-stick surface to limit deposits.
Soft lenses are not the only lenses to cause this – in fact it can occur in the absence of contact lenses! In this case it is a hypersensitivity reaction called Vernal Conjunctivitis. Stronger medicated eye drops may be required to manage the condition.
After an episode of GPC, your chances of enjoying ongoing contact lens success are reduced. It is best to avoid the condition in the first place if possible. if you do develop symptoms of itchy, irritated eyes, see your contact lens practitioner without delay for the best outcome.