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Giant Papillary Conjunctivitis (GPC): Causes, Symptoms, Risk Factors, Diagnosis, Treatment and Complications

Sep 04, 2023

Giant Papillary Conjunctivitis (GPC) Causes, Symptoms, Risk Factors, Diagnosis, Treatment and Complications

The condition known as giant papillary conjunctivitis (GPC) is an allergic ocular reaction. On the inner surface of the eyelid, it appears as one or more little, spherical pimples (papillae).

The lower portion of the eyelid is also known as the upper tarsal conjunctiva. The upper tarsus might develop these lumps when it strikes an unknown object in the eye. If papillae, or pimple, is larger than one millimeter (mm), it is referred to as being gigantic.

Types Of  Giant Papillary Conjunctivitis (GPC)

Primary and secondary GPC are the two types available of GPC. Both reactions are allergic ones although coming from distinct sources.

Primary GPC is divided into two categories:

  • Atopic keratoconjunctivitis (AKC), 
  • Vernal Conjuctivitis VKC

The two primary GPC varieties are very similar to one another. Their fundamental causes, age at symptom start, and other characteristics vary.

Something in the eye, such as contact lenses or a suture, might cause secondary GPC by irritating the inside of the eyelid.

Causes Of Giant Papillary Conjunctivitis

Contact lenses are a common factor in many instances of large papillary conjunctivitis. They consist of:

  • Allergies to the chemicals used to clean or store lenses, or allergies to the lenses themselves.
  • The friction brought on by your lenses rubbing up against your inner eyelid.
  • Proteins, pollen, dust, or other deposits left on the lenses may cause problems.

Other persistent (long-lasting) allergies or friction on the inside of your eyelids are other potential causes of large papillary conjunctivitis that are unrelated to contact lenses. Among these irritants are:

  • Fabricated eyes.
  • Scleral buckles, a piece of plastic or a sponge used to heal retinal tears, or exposed stitches.
  • An elevated pouch used as a filtering device to treat glaucoma.
  • A raised mineral deposit (elevated band keratopathy) on your cornea.

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Symptoms Of Giant Papillary Conjunctivitis (GPC)

The symptoms are the same regardless of what kind of GPC you have. They might consist of:

  • Eye redness
  • Extra mucus
  • Developing bumps on the upper eyelid
  • Swelling,
  • Feeling like there is something alien in your eye
  • Blurred vision.

Later stages of GPC will see an increase and a worsening of the symptoms. The symptoms of large papillary conjunctivitis may not bother you all that much in the beginning. The early stage signs include:

  • Your upper eyelid's underside has a few tiny lumps.
  • Minor eye redness
  • Itching
  • Small amounts of extra mucus in the eyes

The symptoms worsen in the more severe stages of GPC. These signs could be any of the following:

  • Growth in the number or size of the bumps
  • Blurred vision
  • More intense itching
  • Movement of your contact lenses when you blink.

The symptoms typically worsen to the point of being intolerable in the advanced stages of GPC. These signs include:

  • Appearance of new pimples on the underside of the eyelids,
  • Uncomfortable feeling of a foreign body in your eye
  • A painful feeling of a foreign body in your eye when wearing contact lenses, along with new bumps developing on the underside of your eyelids
  • A buildup of mucus that becomes sheets or threads
  • When you get up in the morning, there may be too much mucus on your eyes, which could cause your eyes to stay closed.
  • After being put into your eye, contact lenses may fog quickly. When you blink, more contact lenses move.
  • Allergens are the root cause of primary GPC. The likelihood that you have eczema, asthma, seasonal allergies, or another allergy-related disorder increases if you have primary GPC.

VKC, or Vernal Keratoconjunctivitis

VKC is a chronic illness that often impacts people between the ages of 6 and 18. Your symptoms will often fluctuate according to your seasonal allergies.

Atopic Keratoconjunctivitis (AKC) is a condition that affects people who have atopic eczema that first manifests in childhood. The signs in their eyes, however, typically don't appear until later in life.

Secondary GPC

Using contact lenses is the most typical reason for secondary giant papillary conjunctivitis. especially when wearing soft contact lenses. When compared to people who wear hard contacts, those who wear soft contacts have a tenfold increased risk of developing GPC. Because allergens are more prone to attach to soft lenses than to hard lenses, this rise may be the result of that fact.

Wearers of contact lenses. Among them, 1 to 5 percent will eventually develop GPC. Contact lenses are regarded as prosthetic equipment. Any exposed stitches from an eye injury or operation, as well as any eye or ocular prostheses, might result in GPC. Additionally, specific contact lens solutions may be involved.

What are the Risk Factors of Giant Papillary Conjunctivitis (GPC)?

Giant papillary conjunctivitis risk factors include:

  • Wearing contacts, particularly non-disposable type.
  • Having chronic allergies
  • Undergoing procedures or treatments for your eyes that could leave you with elevated patches on your eyes.

Also Read : Conjunctivitis, Causes, Diagnosis and Treatment

Diagnosis Of Giant Papillary Conjunctivitis 

Your eye doctor will enquire about your indications and symptoms as well as your medical background. You'll receive a thorough eye examination. Your eyelids will be flipped (everted) in order to search for lumps (papillae).

To make the bumps on your eyelids easier to notice, your doctor may occasionally use a dye called fluorescein.

Treatment Of Giant papillary conjunctivitis

If you wear contacts, the first step in treating giant papillary conjunctivitis is to stop wearing them for at least two weeks.

Itching or swelling-relieving eye drops or ointments may be prescribed by your doctor. These topically applied medications could be mast cell stabilizers, antihistamines, or a mix of the two.

Nonsteroidal anti-inflammatory medicines (NSAIDs) and artificial tears without preservatives may also be suggested by your healthcare professional.

Your doctor might advise topical corticosteroids in severe situations.

You may need to have your prosthetic eye (ocular prosthesis) repaired or replaced if you have gigantic papillary conjunctivitis as a result of it.

What Complications can Arise with Large Papillary Conjunctivitis?

Giant papillary conjunctivitis complications include:

  • Itching, mucus production, and the sensation of a foreign body in your eye all get worse.
  • Damage to your cornea's outer layer.
  • Eyelid injury, such as ptosis, or drooping eyelids

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