Management
18
Giant Papillary Conjunctivitis (GPC)
Î Protruding suture knots can be treated by removing, moving, or
replacing the sutures, rotating the knots, or using a therapeutic
contact lens. (III, I, D)
Î Ocular prostheses that cause GPC can be cleaned, polished, or
replaced. (III, I, D)
Î Mild contact-lens-related GPC may respond to replacing lenses more
frequently. (III, I, D)
Î Mild contact-lens-related GPC may respond to decreasing contact lens
wearing time. (III, I, D)
Î Mild contact-lens-related GPC may respond to increasing the
frequency of enzyme treatment. (III, I, D)
Î Mild contact-lens-related GPC may respond to using preservative-free
lens-care systems. (III, I, D)
Î Mild contact-lens-related GPC may respond to administering mast-cell
stabilizing agents. (I+, M, D)
Î Mild contact-lens-related GPC may respond to refitting contact lenses.
(III, I, D)
Î Mild contact-lens-related GPC may respond to switching to daily-wear
disposable lenses. (III, I, D)
Î Mild contact-lens-related GPC may respond to changing the contact
lens polymer. (III, I, D)
Î Associated abnormalities such as aqueous tear deficiency and
meibomian gland dysfunction (MGD) should be treated. (III, I, D)
Î For patients with moderate or severe GPC, discontinuation of contact
lens wear for several weeks to months and a brief course of topical
corticosteroid treatment may also rarely be necessary. (III, I, D)
Î If corticosteroids are used for conjunctivitis, baseline and periodic
measurement of IOP and pupillary dilation should be performed to
evaluate for cataract and glaucoma. (III, I, D)
Î Frequency of follow-up visits is based on the severity of disease and
treatment used. (III, I, D)
Î At the follow-up visit, an interval history, measurement of visual
acuity, and slit-lamp biomicroscopy should be performed. (III, I, D)
