eMedicine Specialties > Ophthalmology > Conjunctiva

Conjunctivitis, Giant Papillary: Follow-up

Author: Barry A Weissman, OD, PhD, FAAO, Chief of Contact Lens Service, Professor, Department of Ophthalmology, Jules Stein Eye Institute, University of California at Los Angeles
Coauthor(s): Karen K Yeung, OD, FAAO, Director of Optometry, Arthur Ashe Student Health and Wellness Center, University of California at Los Angeles
Contributor Information and Disclosures

Updated: Nov 2, 2007

Follow-up

Further Outpatient Care

  • Approximately 80% of patients who develop GPC with CL use can return to comfortable CL wear with appropriate treatment. Frequent encouragement by the clinician can be essential, because the symptoms may take a while to subside.
  • The patient should be frequently monitored while GPC is active, perhaps every few weeks to few months.
  • Once GPC successfully is managed, patients should receive follow-up care as indicated by other aspects of their ophthalmic and medical situation.
  • Patients should be educated about the chronic nature of this disease and its symptoms (eg, ocular itch, mucous discharge, CL intolerance). Patients should be counseled to present within a week of any relapsing symptoms.

Deterrence/Prevention

  • Optimal CL cleaning, replacement, and appropriate/timely professional supervision will minimize occurrence and result in minimal patient symptoms and tissue morbidity.

Complications

  • Decreased CL tolerance and lid ptosis

Prognosis

  • The prognosis is good. Approximately 80% of patients can return to comfortable CL wear with appropriate treatment.

Patient Education

  • Patients should be educated about appropriate CL cleaning and follow-up care. Patients should be advised to return for regular professional evaluations (perhaps once or twice a year if no other complications) but to additionally appoint if they experience any increasing ocular itching, mucous discharge, or dirty CLs.
  • For excellent patient education resources, visit eMedicine's Eye and Vision Center. Also, see eMedicine's patient education articles Pinkeye and Contact Lenses.

Miscellaneous

Medicolegal Pitfalls

  • Use of topical steroid drops, especially for more than a few weeks, is associated with glaucoma, cataracts, and decreased ocular resistance to infection.
    • Topical steroid use is a particular concern in patients with past history of herpetic eye disease.
    • Although topical corticosteroid use is not associated with induction or facilitation of viral recurrence, a fulminant infection could occur if the herpes virus recurs during topical corticosteroid treatment. Increased concerns exist regarding de novo fungal and other viral infections and potentiating bacterial infections.
 


More on Conjunctivitis, Giant Papillary

Overview: Conjunctivitis, Giant Papillary
Differential Diagnoses & Workup: Conjunctivitis, Giant Papillary
Treatment & Medication: Conjunctivitis, Giant Papillary
Follow-up: Conjunctivitis, Giant Papillary
Multimedia: Conjunctivitis, Giant Papillary
References
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References

  1. Spring TF. Reaction to hydrophilic lenses. Med J Aust. Mar 23 1974;1(12):449-50. [Medline].

  2. Aakre BM, Ystenaes AE, Doughty MJ, Austrheim Ø, Westerfjell B, Lie MT. A 6-month follow-up of successful refits from daily disposable soft contact lenses to continuous wear of high-Dk silicone-hydrogel lenses. Ophthalmic Physiol Opt. Mar 2004;24(2):130-41. [Medline].

  3. Allansmith MR, Korb DR, Greiner JV. Giant papillary conjunctivitis induced by hard or soft contact lens wear: quantitative histology. Ophthalmology. Aug 1978;85(8):766-78. [Medline].

  4. Allansmith MR, Korb DR, Greiner JV, Henriquez AS, Simon MA, Finnemore VM. Giant papillary conjunctivitis in contact lens wearers. Am J Ophthalmol. May 1977;83(5):697-708. [Medline].

  5. Chang WJ, Tse DT, Rosa RH, Huang A, Johnson TE, Schiffman J. Conjunctival cytology features of giant papillary conjunctivitis associated with ocular prostheses. Ophthal Plast Reconstr Surg. Jan 2005;21(1):39-45. [Medline].

  6. Donshik PC, Ballow M. Tear immunoglobulins in giant papillary conjunctivitis induced by contact lenses. Am J Ophthalmol. Oct 1983;96(4):460-6. [Medline].

  7. Donshik PC, Ballow M, Luistro A, Samartino L. Treatment of contact lens-induced giant papillary conjunctivitis. CLAO J. Oct-Dec 1984;10(4):346-50. [Medline].

  8. Korb DR, Greiner JV, Finnemore VM, Allansmith MR. Treatment of contact lenses with papain. Increase in wearing time in keratoconic patients with papillary conjunctivitis. Arch Ophthalmol. Jan 1983;101(1):48-50. [Medline].

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Further Reading

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Keywords

giant papillary conjunctivitis, GPC, CL GPC, contact lens giant papillary conjunctivitis, contact lens wear, contact lenses, hydrogel contact lenses, soft contact lenses, allergic conjunctivitis, AC, vernal keratoconjunctivitis, VKC, CLPC

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Contributor Information and Disclosures

Author

Barry A Weissman, OD, PhD, FAAO, Chief of Contact Lens Service, Professor, Department of Ophthalmology, Jules Stein Eye Institute, University of California at Los Angeles
Barry A Weissman, OD, PhD, FAAO is a member of the following medical societies: American Academy of Optometry and Phi Beta Kappa
Disclosure: Nothing to disclose.

Coauthor(s)

Karen K Yeung, OD, FAAO, Director of Optometry, Arthur Ashe Student Health and Wellness Center, University of California at Los Angeles
Karen K Yeung, OD, FAAO is a member of the following medical societies: American Academy of Optometry
Disclosure: Nothing to disclose.

Medical Editor

Anastasios J Kanellopoulos, MD, Assistant Program Director, Clinical Associate Professor, Department of Ophthalmology, Manhattan Eye, Ear, and Throat Hospital, New York University
Anastasios J Kanellopoulos, MD is a member of the following medical societies: American Academy of Ophthalmology, Association for Research in Vision and Ophthalmology, Eye Bank Association of America, and International Society of Refractive Surgery
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Christopher J Rapuano, MD, Professor, Department of Ophthalmology, Jefferson Medical College; Co-Chairman of the Cornea Service, Co-Chairman of Refractive Surgery Department, Wills Eye Hospital
Christopher J Rapuano, MD is a member of the following medical societies: American Academy of Ophthalmology, Eye Bank Association of America, Pennsylvania Medical Society, and Philadelphia County Medical Society
Disclosure: Nothing to disclose.

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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