Eye
Conjunctiva
Conjunctivitis
Giant papillary conjunctivitis
Author: Deepali Jain, M.D.
Last author update: 1 October 2013
Last staff update: 24 December 2020
Copyright: 2004-2023, PathologyOutlines.com, Inc.
PubMed Search: Giant papillary conjunctivitis [title]
Table of Contents
Definition / general | Terminology | Epidemiology | Etiology | Clinical features | Diagnosis | Treatment | Clinical images | Microscopic (histologic) description | Cytology description | Differential diagnosis | Additional referencesCite this page: Jain D. Giant papillary conjunctivitis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/eyeconjgiantpapillary.html. Accessed September 21st, 2023.
Definition / general
- Noninfectious inflammatory disorder due to mechanical and immunologic processes (type I and type IV hypersensitivity)
Terminology
- Also known as "contact lens induced papillary conjunctivitis"
Epidemiology
- Young adults with history of atopy
- 1 - 5% of soft contact lens wearers
- Average onset after 10 - 20 months of contact lens use
Etiology
- Associated with soft, hydrogel contact lenses (Trans Am Ophthalmol Soc 1999;97:205)
- Also exposed sutures, prostheses (Clin Experiment Ophthalmol 2007;35:535, Cont Lens Anterior Eye 2008;31:41), rigid lenses (incidence only 10% of soft lenses)
- Also ocular surgery, foreign body, cyanoacrylate glue
Clinical features
- Itching, burning, foreign body sensation, redness
- Mucus accumulating in inner canthus noticed in morning
- Blurred vision, contact lens coating
- Usually bilateral (10% unilateral)
Diagnosis
- Upper tarsal conjunctiva has inflammation and papules (usually > 0.3 mm)
Treatment
- Change contact lenses more frequently (Eye Contact Lens 2003;29:S37)
- Mast cell stabilizers
- Olopatadine and fluorometholone (Eye Contact Lens 2010;36:210)
Clinical images
Images hosted on other servers:
Giant papillary conjunctivitis
Microscopic (histologic) description
- Thickened and irregular epithelium
- Epithelial cells show polymorphism with greater number of conjunctival goblet cells
- Upper tarsal conjunctival biopsies show mast cells, eosinophils and basophils in epithelium and substantia propria
Cytology description
- Impression cytology: honeycomb pattern consistent with giant papillae, increased inflammation and mucous strands (Ophthal Plast Reconstr Surg 2005;21:39)
Differential diagnosis
- Allergic conjunctivitis
- Toxic conjunctivitis
Additional references
