What is gpc of the eye?

Giant papillary conjunctivitis (GPC) is when the inside of the eyelid gets red, swollen, and irritated because of:

Without GPC, the inside of your eyelid is very smooth.

People who wear contact lenses (especially soft lenses) have the greatest chance of getting GPC. GPC can happen at any time, even after wearing contacts for many years.

People who do not wear contact lenses can also get GPC. But this is rare, mostly affecting those who have an artificial eye or stitches.In giant papillary conjunctivitis, large bumps appear on the underside of the eyelid.

GPC seems to be caused by the following:

At first, the inside of your eyelid gets rough, red, and swollen. Later, you may get bumps—called papillae—that could grow to the size of a pimple.

Other GPC symptoms include:

Contact lenses have become so familiar that both patients and physicians are likely to think of them as innocuous objects. They are widely prescribed for cosmetic reasons as well as to correct a variety of conditions that impair sight. But even the best tolerated contact lens is a prosthetic device on the surface of the eye and, like all prostheses, is foreign to the body. The tissues of the eye and its adnexa therefore mobilize normal responses to foreign bodies. For many contact lens wearers, the result may be minor inconvenience and relatively inconsequential problems with lens tolerance. For others, however, erythema, itching, increased mucus production, and formation of giant papillae on the upper tarsal conjunctiva 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).

It is estimated that GPC affects 1 to 5 percent of the 12 million wearers of soft contact lenses in the United States and perhaps 1 percent of the 8 million wearers of rigid contact lenses. The prevalence of GPC among wearers of hard [polymethylmethacrylate (PMMA)] contact lenses in one large contact lens practice was carefully studied. Of the 200 subjects wearing PMMA contact lenses, 21 (10.5%) had elevated papillae larger than 0.3 millimeters in diameter. Of the control group of 500 non-lens-wearing subjects, only 3 (0.6%) showed elevated papillae larger than 0.3 millimeters in diameter (and two of these were later found to have the early stages of vernal conjunctivitis).

The age distribution of GPC patients is difficult to determine because it is a function of (1) who wears contact lenses, (2) how long they wear them, and (3) what type they wear. Contact lens wearers are usually in their second or third decade. The average length of time patients have worn contact lenses before developing GPC is 8 months for soft contact lenses and 8 years for hard contact lenses.

Patients who develop GPC secondary to their wearing contact lenses for purely cosmetic reasons could, albeit reluctantly, change from contact lenses to wearing eyeglasses. But the proper care of patients who must wear contact lenses (e.g., in the event of keratoconus of high myopia) requires a range of hygienic and medical interventions to manage the possible adverse reactions to wearing contact lenses and to prevent the onset of GPC.

As early as 1950 allergic reactions to wearing plastic contact lenses were reported (MacIvor, 1950). Spring (1974) noted the similarity of a contact-lens-associated disease to vernal conjunctivitis. Complications have been associated with the introduction of hydrogel lenses (Binder, 1980). 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). The relationship between lens deposits and GPC, however, is not clear.

There is no completely successful treatment of contact-lens-associated GPC (Donshik et al., 1984). Removal of the lenses and application of topical corticosteroids and cromolyn sodium have been recommended. We are beginning to understand enough about the pathophysiology of GPC to propose a program for the total management of the disease.

Rather, GPC is a proliferate response to a chronic, physical trauma. The duration and type of stimulus that create this mechanical irritation can also determine the presentation and severity of GPC.

GPC most often originates from contact lens wear. The root of the problem is the lens edge, which rubs against the eye as it blinks 8,000 times per day. This leads to chronic irritation that results in inflammation. The preponderance of GPC in contact lens wearers was originally attributed to an allergy to lens polymer or deposits, contributing to the conditions miscategorization as an allergy.2