GIANT PAPILLARY CONJUNCTIVITIS
Just to say it is a mouthful...I prefer GPC. This condition is essentially one that is exclusive to contact lens wearers. Those people wearing regular (as opposed to disposable) soft contact lenses are at least ten times more susceptible to GPC than rigid (gas-permeable) contact lens wearers. Those patients wearing daily-wear disposable lenses and those wearing rigid lenses are about equally affected. If you sleep in your disposables, you are probably 3 times more likely to have GPC symptoms than if you removed them daily. Those are the statistics, now what in the world is this awful affliction?
Giant papillary conjunctivitis is a condition that mainly affects the underside of your upper eyelids. The conjunctiva is a transparent membrane that covers the white portion of your eye and continues back to also line the underside of your lids. Normally you would think of conjunctivitis as a type of "pink eye". This is true when the inflammation affects the VISIBLE portion of the membrane, but it is still a conjunctivitis if it only affects the "invisible" part that lines the eyelids. The "giant papillary" part of the condition refers to the clinical appearance of the eyelid lining. There, the doctor will find very large bumps or "papillae". Just looking at a patient's eyes may not reveal any signs of the disease, but if the eyelid is everted (a painless maneuver to expose the underside of the lid) the diagnosis can easily be determined.
Generally, there are two theories to explain the onset of giant papillary conjunctivitis. The first is one of "mechanical microtrauma". This could mean that a contact lens is fit too flat or that the lens has a defect causing a chronic irritation to the upper lid. Most likely, though, there is a build-up of protein that has "denatured" on the surface of the lens and it is causing an allergic type reaction in the lid tissue. This is usually the case when a soft contact lens is better than three months old. The importance of good, daily cleaning of soft lenses cannot be overemphasized, for debris accumulation is the cause of the majority of cases.
The earliest signs of GPC will be itching, an increase in mucous production, a desire to remove your lenses earlier in the day, and a gritty, foreign body feeling AFTER removing your contacts. You may also notice that your contacts tend to ride up under your lid or dislocate off the eye quite easily. This is due to the "sticky" nature of GPC.
GPC is NOT serious and will never affect your vision permanently, but it can be a rather frustrating situation. It will demand that you reduce the wearing time of your contacts from a few hours a day to total abstinence. This may last from a week to several months! The papillae may hang around from several weeks to even years! This doesn't mean that you're without contacts for that long but it does mean that extra care in cleaning and frequent replacements may be necessary. Switching to a disposable soft lens or even a rigid contact lens may allow for a more normal wearing schedule while the condition slowly resolves. The advent of ONE-DAY disposable lenses may be a real boost for those suffering from a stubborn case of GPC.
There are also several new drugs (eyedrops) that show great promise in relieving symptoms of GPC. Mast cell stabilizers such as Patanol, Alocril, Zaditor and others have helped many patients overcome GPC and have shortened the time it takes to become symptom free.
So, the bottom line in PREVENTING GPC from occurring in the first place is to stay dedicated to your daily cleaning, maintain a reasonable wearing schedule, and replace your contacts BEFORE symptoms of discomfort become a real issue. If you suspect early symptoms, consult your eye doctor.