In the mild stage, reduced wearing time is the most common
symptom. Many factors can affect comfortable wearing time,
such as lack of sleep, environmental irritants, or dry eyes.
However, persistent loss of wearing time, in the absence
of identifiable reasons, may indicate an early stage of
Giant Papillary Conjunctivitis.
Four stages of the condition
have been identified and described:
Stage 1: Pre-Clinical
The patient has begun to feel discomfort when wearing
contacts, but there is no obvious buildup of deposits
on the contact lenses. There is a mild increase in the
amount of mucus present in the morning and mild itching
when lenses are removed.
Stage 2: Early Clinical
Now a light coating of material has been deposited on
the lens and enlarged papillae are forming. Additionally,
small amounts of mucus are present over the papillae.
Mild redness of the eyes occurs and there is an increase
in the amount of mucus present on awakening. Itching on
removal of lens becomes more severe and the wearer is
much more aware of the lens late in the day.
Stage 3: Moderate
There is a medium to heavy coating of deposit material
on the lens. The number, size, and elevation of papillae
increase; there is a great deal more redness and swelling
of the conjunctiva. Moderate to heavy mucus is often present
in the morning. Itching on removal of lens may be moderate
to severe and may vary on a daily basis.
Stage 4: Severe
The severe stage is accompanied by a heavy deposit of protein
on the lens. Papillae increase in size, number, and elevation.
Redness, swelling, and mucus production become more severe
and some changes in the cornea may be present. Heavy mucus
production is noticed on awakening and eyelids may stick
together.
GPC is a major disappointment to many contact
lens wearers.
GPC can be a disappointing, discouraging condition since
it is primarily caused by long-term use of contact lens.
Some contact lens wearers who have enjoyed lenses for
many years become intolerant and must return to glasses.
Preventive measures for those who
wear lenses should include:
| |
All measures for good
care of your lenses - cleaning, disinfecting, and soaking
with solutions recommended by your eye care professional.
|
| |
Routine measures such
as daily cleaning, as well as weekly cleaning of lens
with an enzymatic solution (to remove protein deposit) |
Preventive measures for gas-permeable lenses
should include:
| |
All possible measures for good care
of lenses. |
| |
Enzymatic cleaning at intervals recommended
by your eyecare professional. |
Treatment
Giant Papillary Conjunctivitis is most difficult to treat.
Discontinuing lens wear is usually required to treat patients
that are in stage 3 or 4. Decreased wearing time, more frequent
lens replacement, or diligent cleaning may be all that is
necessary to improve the condition at earlier stages.
The most effective and easiest treatment of GPC is simply
to discontinue contact lens wear. If this is done, the symptoms
are most likely to disappear.
Of course, many contact lens wearers find this an unacceptable
solution. It may become more palatable if they understand
it need not be forever. If the eyes are given an opportunity
to recover, contact lens wear may be possible at a later
time. However, even after a break, the problem may recur
when lens wear is resumed.
Working with your eye care professional, alternatives can
be explored. For instance, when eyes have recovered, contacts
might be tolerated better if worn on a more limited basis.
Another possibility is that a change in the type of lens
worn may be beneficial in preventing the occurrence of GPC.
Simply replacing the old lenses with new ones is often helpful.
Disposable lens may be a good option for those who experience
problems.
Giant Papillary Conjunctivtis is easier to
prevent than cure.
Even though we do not know exactly what causes Giant Papillary
Conjunctivitis, we do know that protein deposits are a likely
contributing factor, so meticulous attention to cleaning
is important. In addition, a well-fitted pair of contact
lenses is essential to prevent problems such as giant papillary
conjunctivitis.
Remember . . .
Giant Papillary Conjunctivitis is treatable and there are
many options to explore before "giving up" on
your contact lenses. Working together, you and your eyecare
professional can explore alternatives for care and develop
a plan for continued clear and comfortable vision.
