Giant Papillary Conjunctivitis or GPC can be quite a tricky condition if left untreated for too long. Most patients are asymptomatic to start and slowly develop contact lens awareness or lid awareness when they blink.
What is GPC?
GPC is identified by its large papillary reaction in the conjunctiva – the portion that is on the inside of the eyelids. There are a couple different causes for GPC, but I will focus on the more common forms seen in clinic. In all cases, GPC is caused by chronic allergic reactions.
Any time you get a mosquito bite, histamine is what makes it itchy. And, itching it makes it MORE itchy! This is because the physical act of scratching creates small amounts of damage to the surface of the skin – and this releases MORE histamine…to get you to scratch it again. This entire process increases inflammation as well. The same thing is going on in your eye on a much smaller scale:
- An allergen/particle is introduced to your eyelid.
- Your eyelid responds by increasing histamine/inflammatory mediators to bring your attention to it and get your body to try to heal it – you probably don’t even feel this part because its so tiny
- The blinking motion of your eyelids is perceived as a scratch, and therefore the bumps get larger. This then releases more histamine/inflammatory mediators.
- Finally, one day you feel something and it is uncomfortable. Patients describe it as irritation or contact lens awareness
Contact lenses are one of the larger contributors to GPC that I see in clinic. Each day, pollen and allergens accumulated on the contact lens are re-used and irritate the eye more and more. The important part to Contact lens-induced GPC is that you can actually trick your body into thinking it is allergic to contact lenses. This is what is so important to prevent.
What to do?
- Take a break – from contact lenses for a while until things calm down
- Find your allergen. Contact your allergist and figure out which allergen may be the culprit.
- Put in a drop – using a daily allergy eye drop can reduce symptoms significantly.
- Switch to daily contact lens replacement – new lens each day, no allergens accumulated from days prior. Less bulk for your eye to handle.
- Don’t be a stranger. Go see your eye doctor whenever you think you may have a flare-up. We will help you get back to normal safely and as quick as possible.
- Short course of steroid eye drops can get you back in contact lenses much faster
Be patient with your condition. This is one of the more tricky conditions as I said before. If you try to push your eyes too much, the likelihood of successful contact lens wear in the future is reduced dramatically. I want you to be wearing contact lenses until you’re 90…it’s a marathon, not a sprint!