Hey everyone, it’s Medicine Mondays —- but on Tuesday! Today is kind of a follow-up post to Take Care of Your Eyes and Part Two. We’re going to talk about Giant Papillary Conjunctivitis.

Giant Papillary Conjunctivitis?

Yea.

I think I may have mentioned it in passing in my prior few posts, but I wanted to devote a whole post to this topic. Most likely my wife and I both have some form of this disease. It’s not life-threatening necessarily, but it can significantly decrease your quality of life —- and you may suffer for longer than necessary if you don’t know about it.

There are a lot of good articles which explain what it is, but I’m going to try to make it simple for everyone to understand.

Basically, Giant Papillary Conjuctivitis (GPC) is a hypersensitivity reaction. It was originally thought to be some kind of allergic response because of the similar symptoms to allergy sufferers, but now it’s considered non-allergic.

For more on the hypersensitivity reaction, go here:
Treatment of Giant Papillary Conjunctivitis

Basically, any ocular prosthetic (including contact lenses) increases the chances of getting this particular disease. However, there may a compounding effect in those who have allergies though, which would increase their likelihood of getting this disease.

So what happens?

Well, there are stages but basically it’s a hypersensitivity response. The body thinks there is a foreign body in the eye and is trying to get rid of it.

Reference: Heathline
Medically reviewed by Ann Marie Griff, OD on March 13, 2018
Written by Diana Wells

Stages of GPC

In the early stages of giant papillary conjunctivitis, the symptoms may not bother you very much. The early stage symptoms include:

• smaller bumps on the underside of your upper eyelid
• mild itching
• mild redness of the eye
• small amounts of excess mucus in the eye

In the severe stages of GPC, the symptoms become more uncomfortable. These symptoms may include:

• an increase in the number or size of the bumps
• more intense itching
• blurred vision
• excess mucus developing more quickly and in larger amounts
• movement of your contact lens when you blink

In the advanced stage of GPC, the symptoms usually become intolerable. These symptoms include:

• additional bumps appearing on the underside of the eyelid
• an intolerable sensation of a foreign body in your eye
• pain when wearing your contact lenses
• excess mucus becoming strings or even sheets
• your eyes may stick closed by the excess mucus when you wake up in the morning
• excess deposits on your contact lenses
• contact lenses may cloud soon after being inserted into your eye
• increased movement of a contact lens when you blink

Basically, the normal symptoms are a redness/swollen feeling to the underside of your eyelids. As the disease progresses, you develop little bumps (papillae) which get larger as the disease progresses further. If this continues, you risk damage to your cornea. Obviously, you don’t want it to get this far but it was likely you would seek medical attention before that occurred because the symptoms at this stage are pretty much intolerable.

Why are you telling me this?

Well, my wife and I both wear contact lenses. This disease affects contact lenses wearers — and you are more at risk the longer you wear them for. Ideally, you should only wear contact lenses 8 hours a day. The remainder of the day (16 hours) you shouldn’t be wearing them.

Now then, I don’t know about everyone else, but I would guess that the majority of contact lenses wearers use them for much longer than 8 hours a day. For example, if you have to wake up early for work, you may put your contact lenses in as early as 6 am. Then if you go to work, come home, eat dinner, and maybe take your contact lenses out after you get a shower around 8 pm. That’s a 14 hours of contacts in your eyes, almost double the “ideal” usage.

Obviously, this places you at significant risk for GPC. I would venture a guess that the majority of doctors who wear contact lenses are not only using them for only 8 hours a day. Most likely it is closer to the 14 hours I described above. As such, I would guess that this particular disease is not uncommon (or maybe even common) as well as underdiagnosed in doctors who wear contacts.

This is kind of another “suffering in silence” thing that I think people just kind of get used to. Like your contact lenses get uncomfortable so you just wear your glasses for a week or two and they feel better — only to get bad again when you wear your contacts again. You didn’t fix the problem, you’re just band-aiding it by wearing your glasses for a little while to give your eyes some rest. You probably don’t know why this happens but have brushed it off something that contact lenses wearers just “deal with”.

It’s not.

What should I do?

Well, the first thing you should do is when you see your optometrist, you should be aware that when they flip your eyelids, this is what they are checking for. Make sure to ask about it every time you see yours.

If you already have these symptoms, it might be worthwhile to make an appointment to see your optometrist or ophthalmologist sooner rather than later.

In the mean time, the first thing you should probably do is stop wearing your contact lenses for so long everyday. My optometrist suggests less than 8 hours of continuous usage. If you have to wear them longer than that then you need to take the contacts out, soak them in solution (without preservatives), and use re-wetting eye drops (unpreserved saline) before putting them back in. However, this may be difficult if you wear daily contact lenses because at least for me, once I take them out I can’t get them back in.

So the best solution is probably to put your contacts in and wear them during the day, but once you get home from work, just take out your contacts and switch to glasses. In general, that should help you keep the continuous usage down to less than 10 hours, and hopefully 8. The other option would be to only wear your contacts lenses while at work — driving to work with glasses, putting in your contacts at work, and then taking them out to drive home.

If you think you are already in the advanced stages of this disease, please see your doctor right away and stop using your contact lenses. By advanced stages, I mean as soon as you put your contact lens in your eye, it clouds up and you can’t see, foreign body sensation, mucus, and discomfort/pain is pretty much intolerable.

If you feel like you’re being forced to wear your glasses because your contacts are too uncomfortable then you should give your eyes a break. Just wear your glasses only for awhile until you can see a doctor.

What are you doing?

Well, I think I probably have stage 1 GPC — not quite 2. Now that I’m aware of it, I’m trying my best to wear my contact lenses for less hours continuously. This is kind of difficult since I work a ten hour shift, but I’m going to try to put my contacts in just before I go to work and take them out immediately when I get home.

Once I switch back over to my biweekly contacts, I’m going to make a concerted effort to take my contacts out at work, clean them, and give my eyes a little breather before putting them back in again — maybe in the middle of my shift. I’m going to try to keep extra contacts (and my glasses) with re-wetting drops and contact lenses solution at work too.

Other references:

Giant Papillary Conjuctivitis – American Academy of Ophthalmogy
Written By: Kierstan BoydReviewed
By: Brenda Pagan-Duran MD
Nov. 30, 2018

Giant Papillary Conjunctivitis – VeryWellHealth
By Troy Bedinghaus, OD
Medically reviewed by a board-certified physician
Updated March 17, 2019

GPC: Don’t Call it An Allergic Reaction – Review of Optometry
Terry Chin, O.D.
Published October 24, 2006

TL;DR

Take care of your eyes — Giant Papillary Conjuctivitis edition.

I think this particular ailment is more common than we think — and the likelihood is that is probably more common in doctors who wear contacts since we work longer hours continuously.

In other news, Happy Anniversary to my wife… it’s been an amazing 8 years — so many adventures already and so many more adventures to have!

For those wondering:
Hallmark Paper Wonder Card Pop-Up Card (Paris)
Precious Moments – Our Love is Deeper than the Ocean

I didn’t buy them from amazon, I’m just using those links so you can see the items and other similar options.

-Sensei

Agree? Disagree? Questions, Comments and Suggestions are welcome.

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