Considerations in Contact Lens Use Under Adverse Conditions Proceedings of a Symposium (1991) / Chapter Skim
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Treatment of Giant Papillary Conjunctivitis
Treatment of Giant Papillary Conjunctivitis
Pages 74-83
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From page 74... ...
For others, however, erythema, itching, increased mucus production, and formation of giant papillae on the upper tarsal conjunctive may make prolonged wearing of contact lenses impossible. This disease related to wearing contact lenses and other ocular prostheses is now recognized as giant papillary conjunctivitis (GPC)
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From page 75... ...
Lens deposits have been identified as a major complication of extended-wear soft contact lenses (Binder, 1979) and a possible contributing factor to GPC (Allansmith and Ross, 1987~.
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From page 76... ...
do not include such features of GPC as increased tissue mass, presence of many inflammatory cells, extensive infiltration with eosinophils, increased number of mast cells in the substantia propria and epithelium, and the presence of basophils. The cellular infiltrate of giant papillary conjunctivitis and vernal conjunctivitis suggests a common immunologic basis for the two diseases (Allansmith et al., 1979~.
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From page 77... ...
Some patients may continue wearing their soft contact lenses despite scores of giant papillae covering both upper tarsal plates. Other patients may stop wearing their soft contact lenses because of the itching and increased mucus, although the only definitive sign of GPC is conjunctival thickening.
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From page 78... ...
Six conditions favor the development or exacerbation of GPC: increased deposits on the lenses, increased time per day that lenses are worn, use of lenses consistently for months or years, individual reactivity to wearing a particular lens type, larger lens and therefore broader area of adhering antigenic material, and genetic constitution of the patient. The treatment of GPC depends on three therapeutic strategies: teaching the patient to clean the lens, finding the best tolerated lens, and treating the conjunctival inflammation.
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From page 79... ...
Of the two enzyme preparations on the market the proteolytic enzyme papain and a pancreatic enzyme containing lipases and proteolytic enzymes—the papain enzymatic cleaner seems to be more effective in removing deposits and quieting the GPC. Type of Contact Lens Lens of the Same Design In many patients GPC can be controlled by reestablishing good cleaning practices, a new lens of the same design, and replacing the contact lenses every 6 to 12 months.
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From page 80... ...
Withdrawal of Lenses Contact lenses must be withdrawn under certain pathologic conditions: (1) staining of the tops of the giant papillae when fluorescein is introduced to the tear film, (2)
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From page 81... ...
Clinical signs were likewise improved after treatment with cromolyn sodium. Cromolyn sodium reduced hyperemia in the bulbar conjunctive and upper and lower tarsal conjunctive, diffuse infiltration and size of palpillae in the upper tarsal conjunctive, and mucous production in the lower tarsal conjunctive and fornix.
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From page 82... ...
Korb, and J.V. Greiner 1978 Giant papillary conjunctivitis induced by hard or soft contact lens wear: quantitative histology.
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From page 83... ...
1982 Giant papillary conjunctivitis management in hydrogel contact lens wearers. Journal of the British Contact Lens Association 5:94-99.
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