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Giant papillary conjunctivitis

Pedram Hamrah, MD
Reza Dana, MD, MPH, MSc
Section Editors
Bruce S Bochner, MD
Robert A Wood, MD
Deputy Editor
Elizabeth TePas, MD, MS


There are five main types of ocular allergy: seasonal allergic conjunctivitis (SAC), perennial allergic conjunctivitis (PAC), vernal keratoconjunctivitis (VKC), atopic keratoconjunctivitis (AKC), and giant papillary conjunctivitis (GPC). GPC is a noninfectious inflammatory disorder that represents a reaction to lid movement over a foreign substance, such as contact lenses. It is characterized by foreign-body sensation on the upper tarsus, associated with formation of "giant" (>1 mm) papillae. GPC is reviewed here. Other contact lens-related complications are discussed separately. (See "Complications of contact lenses".)

VKC and AKC are chronic, bilateral, and severe forms of allergic inflammation affecting the ocular surface. These two relatively uncommon types of allergic eye disease can cause severe damage to the ocular surface, leading to corneal scarring and vision loss if not treated properly. VKC and AKC are discussed in detail separately. (See "Vernal keratoconjunctivitis" and "Atopic keratoconjunctivitis".)

SAC and PAC, the most common forms of ocular allergy, are also discussed separately. (See "Allergic conjunctivitis: Clinical manifestations and diagnosis".)

Toxic conjunctivitis is not allergic in nature, but it is frequently confused with allergic ocular disease. It develops with protracted use of topical medications, mostly due to preservatives. Toxic conjunctivitis is discussed separately. (See "Toxic conjunctivitis".)


GPC is most commonly associated with wearing of contact lenses and is seen more frequently with soft, hydrogel lenses rather than rigid, gas-permeable (RGP) lenses [1-3]. Approximately 1 to 5 percent of soft contact lens wearers have clinical signs of GPC, and the prevalence is approximately 10-fold less in rigid lens wearers [1]. This difference in prevalence is probably because allergens adhere more readily to the surface of soft contact lenses. Additional factors that influence the incidence of GPC in contact lens wearers include wearing time of contact lenses, cleaning routine (frequency and types of solutions), and duration of contact lens wear [4]. The average onset of GPC after start of contact lens wear is 10 to 20 months for soft contact lenses and 22 to 90 months for rigid lenses [2,3]. However, symptoms may occur as early as three weeks after the start of contact lens wear.

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Literature review current through: Nov 2017. | This topic last updated: Dec 20, 2016.
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