Giant papillary conjunctivitis (GPC) causes swelling, redness, and irritation in the lining of the membrane inside your eyelids. Contact lens wearers have the highest risk of developing GPC. People with an artificial eye or eye stitches can also be at risk.
Treatment for GPC can help prevent long-term vision issues. So, it’s best to see an eye doctor, such as an optometrist or an ophthalmologist, soon after you start getting symptoms. “Usually with GPC, there’s something that’s irritating the eye. And so, not only treating the inflammation but trying to figure out what’s causing it is important,” says Laura Margaret Di Meglio, OD, an optometrist and assistant professor of ophthalmology at the Wilmer Eye Institute at Johns Hopkins in Baltimore.
Here’s everything you need to know about GPC causes, symptoms, and treatments, and how to help prevent it.
What Causes Giant Papillary Conjunctivitis?
GPC is an issue that usually affects people who wear contact lenses. Any type of contacts can cause GPC, including soft lenses, rigid lenses, hydrogel lenses, and silicone hydrogel lenses.
Pollen or other irritants in the air can build up on your lenses and cause GPC. You can also get GPC if foreign bodies get trapped beneath your eyelids or you have loose stitches left in your eye after surgery.
What are the risk factors for developing GPC?
Some risk factors for getting GPC are:
- Regularly wearing contact lenses (especially the kind you reuse for weeks or longer) or using those with poorly made edges
- Having asthma, hay fever, or other allergies (including allergic reactions to contact lenses or chemicals used to clean the lenses)
- Getting eye surgeries or treatments that may lead to raised spots on your eyes
- Having an eye condition called meibomian gland dysfunction
What Are the Symptoms of GPC?
The GPC symptoms that you might notice first are roughness, swelling, and redness on the insides of your eyelids. Often, this involves feeling extra sensitivity when you close your eyes, especially when you don’t have your contact lenses in. Then you might get bumps called papillae on the insides of your eyelids. These can grow as big as a pimple.
Other symptoms of GPC can include:
- The feeling that something is trapped in your eye
- Swollen or droopy eyelids
- Blurry vision because of too much mucus
- Red and painful eyes
- Itchiness
- A contact lens that feels like it’s moving up your eyeball after blinking
Taking out your contact lenses can make your symptoms more intense. That’s because lid movement increases the production of substances that affect your blood vessels, including histamines.
Eye conditions that bring on symptoms similar to GPC include:
- Seasonal allergic conjunctivitis
- Atopic conjunctivitis
- Viral conjunctivitis
- Blepharitis
Get a checkup with an eye doctor if your eye irritation doesn’t clear up. Without treatment, GPC may damage your cornea and eyelid and permanently affect your vision.
How Is Giant Papillary Conjunctivitis Diagnosed?
There are no specific lab tests to diagnose GPC. Some doctors recommend checking a person’s tears for higher levels of immunoglobulin E (IgE). That’s a type of protein your immune system makes to help protect you from infections, but too much IgE can also lead to allergic reactions.
Most of the time, doctors diagnose GPC by checking the size of any bumps beneath your eyelids and asking if you wear contact lenses. They also look at how the lenses move on your eyes when you blink and check your contact lenses for damage or eye deposit buildup.
Can GPC Affect Contact Lens Users Differently?
If an issue with contact lenses causes GPC, the condition might bring on discomfort and itching only while you’re wearing your contacts, Di Meglio says. And usually, you can practice simple habits that can help with your symptoms.
Along with not wearing reusable lenses longer than the manufacturer recommends, she says it may help to try a hydrogen peroxide lens cleaner. Also, gently rub your lenses each time you clean them. Rubbing can help remove anything that is stuck on the lenses, such as a buildup of protein.
GPC is less common in people who don’t wear contact lenses. In fact, it’s rare. If the cause isn’t something that’s removable (such as contact lenses), then it might lead to symptoms that's even more annoying, Di Meglio says.
How Do Doctors Treat Giant Papillary Conjunctivitis?
GPC treatment may include medicines, changing the type of contact lenses you wear, or changing your lens-cleaning routine. Your doctor may also ask you to not wear your contacts for a few days or longer. This gives the inside of your eyelids time to heal.
Medications. Depending on the state of your eyes, your doctor may prescribe an ointment or eyedrop medicine to help with any swelling or itching. Applying cold compresses to your eyes can also offer relief from your symptoms.
Medications such as a mast cell stabilizer/antihistamine ophthalmic solution can help with severe cases of GPC. You may also get this treatment if you have a condition like keratoconus, in which you need to keep wearing contacts in order to see.
Your doctor may give you a short-term prescription for steroid eye drops. You shouldn’t use them for more than a few weeks because they could raise your odds of getting other eye problems such as:
- Glaucoma
- Cataracts
- Lower protection against eye infections
Most people with GPC can start wearing contact lenses again after getting treatment.
Changes to contacts or lens-cleaning routine. Your doctor might ask you to change your contact lens cleaning solution, wetting drops, or lens soaking products.
Changing your lens cleaning routine can help cut down on the amount of buildup on your contacts. Look for salt-based solutions rather than those with preservatives. If you wear rigid contact lenses, make sure you clean them with an enzyme at least once or twice per week.
Your doctor may also suggest trying a different type of contact lens, such as daily disposables. You throw them away after one day, which lowers your chances of getting GPC again. Avoid using any products that contain hydrogen peroxide with these lenses.
If disposable contacts irritate your eyes, your doctor may recommend gas-permeable lenses. They’re shaped differently from other contacts, making them less likely to rub against your eyelids.
How Can You Prevent Giant Papillary Conjunctivitis?
Try these tips to help lower your risk of getting GPC:
- Get regular eye exams, especially if you have conditions such as eczema or asthma that allergies may trigger.
- If pollen played a role in your GPC, stay away from grasses and trees during the pollen season. Use the air conditioner in your home and car, and keep doors and windows shut as much as possible.
- Wash your hands before you handle your contact lenses.
- Rinse lenses, and rub lenses with cleaning solution. Try not to use solutions that have preservatives in them.
- Don’t wear your contact lenses for longer than recommended, and take them out before you go to sleep.
What Is Papillary Conjunctivitis, and How Is It Related to GPC?
Papillary conjunctivitis is an umbrella term for conditions that involve bumps (called papillae) on the insides of your eyelids. With papillary conjunctivitis, the bumps tend to be smaller. With GPC, they’re larger, which is where the description “giant” comes from, Di Meglio says.
“Giant papillary conjunctivitis is usually found on the upper eyelid, and it’s its own entity. So, GPC will be a papillary conjunctivitis, but not all [types of] papillary conjunctivitis are giant,” Di Meglio says.
What Is Giant Papillary Conjunctiva?
There’s no such thing as giant papillary conjunctiva, Di Meglio says. It’s not an actual condition.
The conjunctiva is the thin, clear layer of tissue that protects your eye. It lines the white of your eye and the inside of your eyelid. Conjunctivitis, also known as pink eye, is an inflammation of that tissue.
Takeaways
Giant papillary conjunctivitis (GPC) is a condition that causes swelling, redness, and irritation inside your eyelids. People who wear contact lenses have the highest risk of getting GPC. People with an artificial eye, stitches in the eye, or allergies can also be at risk. Without treatment, GPC can cause long-term damage to your vision. Treatment may include medicines or trying a different type of contact lenses. Most people can go back to wearing lenses after their eyes have healed.
GPC FAQs
Is GPC the same as allergic conjunctivitis?
No. These conditions are similar, but they’re not the same. Both conditions inflame the protective tissue (conjunctiva) that covers your eyelids and the whites of your eyes. But GPC is usually caused by wearing contact lenses; allergies rarely cause it. Allergic conjunctivitis is a condition in which an allergen causes inflammation.
Both conditions also can bring on bumps called pappilae on the insides of your eyelids. GPC causes large bumps in your upper eyelids, while allergic conjunctivitis can bring on small bumps in your lower eyelids, Di Meglio says.
Can giant papillary conjunctivitis go away on its own?
It can, depending on what’s causing it, Di Meglio says. When GPC is due to the use of contact lenses, she says, taking a long break from wearing the contacts might cause the condition to slowly get better on its own. Still, if you have symptoms of GPC, it’s best to get a checkup with an eye doctor as soon as possible, she adds.
What is the difference between GPC and regular conjunctivitis?
Both conditions involve inflammation of your conjunctiva, but their main causes and symptoms aren’t identical. Contact lens use is the most common cause of GPC. Much less often, allergies are the culprit. But those are just two possible causes of regular conjunctivitis, also called pink eye. Among its many possible causes are infections from viruses or bacteria. Infectious pink eye can spread from person to person, but GPC can’t.
And even though pink eye and GPC can both bring on symptoms such as redness, itching, and the feeling of having something your eye, pink eye isn’t known for causing large bumps on the insides of your upper eyelids.
Is GPC a chronic or temporary condition?
With fast treatment, GPC is a temporary condition. But there’s a chance you could get it again someday. If you’ve gotten treatment for GPC and your symptoms come back, see your eye doctor right away. If contacts lenses are the reason for GPC’s return, your doctor might ask you to stop wearing contacts and switch to glasses.
