Justin Bazan, OD Park Slope Eye
(- I Care -) Your Eyes Advocate

GPC Giant Papillary Conjunctivitis

Giant Papillary Conjunctivitis

case4b.jpgGiant Papillary Conjunctivitis (GPC) is an immune-mediated, inflammatory disorder that is a response to the presence of an irritant. That irritant can be an allergen, a contact lens, an ocular prosthesis, an exposed postoperative suture (stitch), a contact lens solution or even the dirty deposits of bacteria and buildup that accumulates in and on a contact lens. Basically something interacts with the inside of your eyelid to the point where it becomes irritated and bumpy, leaving your eye very uncomfortable.It is most commonly associated with soft contact lens use, especially contacts that aren’t being thoroughly rubbed cleaned, thrown out frequently and/or are worn for long hours (especially overnight). Although GPC can be extremely uncomfortable and annoying to deal with, it is NOT a dangerous condition and it will not cause permanent vision loss or cause permanent damage to your eyes.  It is also ok to go to work, as it is NOT contagious.

Many eye doctor’s call GPC in contact lens wearers Contact Lens Induced Papillary Conjunctivitis (CLPC). CLPC can cause your eyes to feel horrible. Many people will have symptoms that include tearing, significant mucus production, and itching. The eyes will most commonly present as red, irritated and uncomfortable. Sometimes the eyes will even feel worse after the contact lens is removed, because the contact was acting as a protective layer between the sensitive cornea and the bumpy lid that is rubbing against it. The presence of the irritant (ex, prolonged exposure to a dirty contact) leads to the production of giant papillae (bumps) on the under surface of the upper eyelid. One may think of it as a rash in response to touching something irritating, like poison ivy.

Here is what makes sense to me. The longer you wear a contact lens the more irritating it is to your eye. The dirtier the contact lens the more irritating it is to your eye. Therefore the ideal formula for irritating your eye, is wearing a d0082444284987_215x215.jpgirty contact for as long as possible.That would also explain why people who sleep in there lenses are 3 times more likely to experience GPC than a normal daily use contact lens wearer. Furthermore, I have personally never seen CLPC exhibited in a patient who uses a brand new lens everyday, ie a daily disposable contact lens wearer. Therefore, I am attributing CLPC in the majority of my contact lens patients to wearing a not so clean contact for too long of a period. The good news is that I can help provide the ways and means to return you to healthy and comfortable contact lens wear.

GPC is a fully reversible condition in the great majority of cases simply discontinuing contact lens wear. I recognize that I would be hard pressed to find a patient who would be 100% compliant with the idea of suspending contact lens wear indefinitely. There for I have adopted the following care package which will get you back into contact lenses as quick as possible. However, I will state that contact lens wearers with significant signs and symptoms of GPC, should ideally discontinue use of contact lenses until a noted improvement of the signs and especially the symptoms of the disorder have resolved. The giant papillae themselves may not fully disappear for many months or years even after removal of the contact lenses although the symptoms will have surely been long resolved. Most likely you will be out of contacts for a few days to about a week.

patadayboxbottle-home.jpgMy treatment plan is highly effective, geared towards the fastest resolution, and the minimization of the chance of recurrence. It most certainly will involve a change into a daily disposable contact if possible. If a daily disposable is not an option, we would implement a strict contact lens hygiene regime consisting of a rub-rinse-soak routine (Opti-Free Replenish or Clear Care) and the most frequently replaced lens available. Finally, cold compress and artificial tears/rewetting drops may be implemented several times daily which may afford additional relief by providing a moisture rich barrier between the lid and the lens. It will also include the use of medication to help return the eyelid to a normal condition and to alleviate the symptoms. Typically Pataday, an antihistamine/mast-cell stabilizer will be utilized. For patients with particularly severe GPC, a short course of corticosteroid eye drops (ie. FML, Alrex, Lotemax) may be prescribed alternatively or in conjunction with the Pataday. Both agents will help to control and suppress certain aspects of the inflammation associated with the GPC, leaving you eye feeling a lot better.

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6 Responses to “GPC Giant Papillary Conjunctivitis”

  1. Hi doctor, my name is Cameron and in February I began to have irritating eye problems. I saw an ophthalmologist and he diagnosed me with GPC. Since then, I have suspended wearing my Acuvue 2 soft contact lenses and just been wearing my glasses. The ophthalmologist suggested I get fitted for RGPs, and I did. However, the RGPs are extremely uncomfortable. I have been researching extensively about GPC and the options for individuals. I came across your site and I find it very helpful. I really don’t like wearing my glasses; it’s difficult to participate in many sport-related activities. I’ve considered LASIK, but I’m too young. I’m 20. While researching GPC, I see that daily disposables are ideal option. My main concern is that once I start wearing soft contacts again, the GPC will re-emerge and another visit to the ophthalmologist. I’ve worn Acuvue 2 for years and just recently developed GPC. I also have been experiencing the worst allergy season ever and my allergist says that it may have contributed to the GPC. Also, while I was wearing my Acuvue lenses, I used the “no-rub” solution and thus, I never rubbed and cleaned the contacts, which I believe was a major culprit to my problem. I rarely ever slept with my contacts. What are some suggestions you may have for daily disposables and the brands that would be beneficial?

  2. Hi Doctor,
    I am a hard patient to fit. I have a high astigmism in my eyes. I have a history of GPC which I think has returned. Will anyone make a daily lens for a hard to fit person if I am willing to pay?

  3. Thanks for this article, I found it very helpful and informative… unfortunately I have tried EVERYTHING and my symptoms still persist.
    Here’s my saga. I have been wearing contacts for 12 years, I am 24. And I’ve been battling GPC for the last year, on and off. I have always used Acuvue brand contacts, and am currently in Acuvue Oasis with Hydro-clear (I think). I have tried many other brands, however none fit my eye correctly (apparently I have a steep cornea, according to my eye doctor) In addition, my prescription is +7.00 (horrible eyesight!) So daily disposables are out of the question because no manufacturer makes them in my prescription. I use Clear Care and change my 3 week disposables ONCE a WEEK. Talk about raking up contact costs! I use re-wetting drops often, and am on a steroid (FML) to “clear” up the GPC, which I use 4 times a day. It seems like it gets better, I wear contacts again, and the vicious cycle happens over and over and over. I am not a candidate for Lasik, tried that. Is there any relief, besides wearing my glasses for the rest of my life??

  4. I had worn contacts for about 10 years before my GPC flared up. I discontinued my contact use entirely for two months while using a steroid drop and artificial tear drop. When I went back to the doctor, he said my eyes were still bad. I never slept in my contacts, always cleaned them with Clear Care, very rarely wore them for more than 9 hours a day, and don’t have allergies. I even tried the daily lenses. But somehow this happened and now my doctor says I can’t wear contacts anymore. 😦

  5. Hi doctor, I have been diagnosed with mild GPC and I have laid off from contact lens for about 7 months now and I am dying to wear contacts again.. I never really felt the symptoms. I only learned it from my doctor. He told me that I should not wear contacts ever again. If this is a reversible condition, why did he tell me that? Please give me a peace of mind, thank you 🙂

    -rana

  6. I haven’t worn contact in 2 years since being told I had GPC. I still have ANGRY eyes as I call them. They flare up especially at night. I really thought all this would clear up by giving up contacts, but for me it hasn’t gotten much better. I even went through the eye drops and antihistamines, I don’t know what else to do. I doubt I’ll ever wear contacts again, they just irritate my eyes more and spin and move, so frustrating.


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