Giant papillary conjunctivitis (GPC) is an allergic reaction of the eye. It occurs when one or several small round bumps (papillae) develop on the underside of the eyelid.
Thank you for reading this post, don't forget to subscribe!The underside of the eyelid is also called the upper tarsal conjunctiva. These bumps develop when the upper tarsus rubs over something foreign in the eye. The term giant refers to the bumps, or papillae, being larger than 1 millimeter (mm) in size.
There are two types of Giant papillary conjunctivitis, primary and secondary. Both are responses to allergens but have different causes.
Primary Giant papillary conjunctivitis has two types which are:
- Vernal keratoconjunctivitis (VKC)
- Atopic keratoconjunctivitis (AKC)
The two types of primary Giant papillary conjunctivitis have many similarities. They differ by having different primary causes and the age and manner of symptom onset.
Secondary Giant papillary conjunctivitis is caused by something in the eye that’s irritating the inside of the eyelid, such as contact lenses or a suture.
Symptoms of Giant Papillary Conjunctivitis
No matter what type of Giant papillary conjunctivitis patient have, the symptoms are similar.
They may include:
- Bumps that begin to form on the underside of upper eyelid
- Itching
- Feeling like there’s a foreign object in eye
- Eye redness
- Forming excess mucus
- Swelling
- Blurry vision
The symptoms of Giant papillary conjunctivitis will increase and become more severe in later stages.
Stages of Giant Papillary Conjunctivitis
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 Giant Papillary Conjunctivitis, 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 Giant papillary conjunctivitis, 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 the eye
- Pain when wearing contact lenses
- Excess mucus becoming strings or even sheets
- Eyes may stick closed by the excess mucus when patient wake up in the morning
- Excess deposits on the contact lenses
- Contact lenses may cloud soon after being inserted into the eye
- Increased movement of a contact lens when patient blink
Possible causes
Primary Giant papillary conjunctivitis is caused by allergens. If you have primary Giant papillary conjunctivitis, you’ll most likely have seasonal allergies, asthma, eczema, or another allergy-related condition.
Vernal keratoconjunctivitis (VKC)
Vernal Keratoconjunctivitis (VKC) is a chronic condition and usually affects those between the ages of 6-18. Usually, the symptoms will come and go based on seasonal allergies.
Atopic keratoconjunctivitis (AKC)
Atopic Keratoconjunctivitis (AKC) affects those with atopic eczema that starts when they’re young. However, the symptoms in their eyes usually don’t start until later in adulthood.
Secondary Giant papillary conjunctivitis
The most common cause of secondary giant papillary conjunctivitis is the use of contact lenses. More specifically with the use of soft contact lenses.
Those who wear soft contact lenses, they are 10 times more likely to develop Giant papillary conjunctivitis when compared to those who wear hard contacts.
The reason for this increase may be because allergens are more likely to stick to soft lenses than hard lenses.
Contact lenses are considered prosthetic devices. Other eye or ocular prostheses can cause Giant papillary conjunctivitis, as well as any exposed stitches one may have from an eye injury or procedure. Also, certain contact lens solutions can play a role in causing Giant papillary conjunctivitis.
Treatment
If Giant papillary conjunctivitis is caused by wearing soft contact lenses, the quickest way to treat the condition is to switch to wearing eyeglasses or hard contact lenses instead of soft contacts.
Some patients may also be able to manage or eliminate Giant papillary conjunctivitis by switching between contacts and eyeglasses. Alternating can give the eye time to rest and reduce the irritation caused by the soft contacts.
Treating primary Giant papillary conjunctivitis
The preferred treatment for primary Giant papillary conjunctivitis is cromolyn sodium and lodoxamide. Other treatment options for both types of primary Giant papillary conjunctivitis include:
- Antihistamines. Antihistamines may work for some, but may not be strong enough for others.
- Topical steroids. Although these are prescribed, they can’t be used long term due to negative side effects associated with long-term use.
- Topical cyclosporine.
Here are some Homeopathic medicine for safe and permanent treatment:
1- Apis Melifestida and Eyeballs Burning
Lids swollen, red, oedematous, everted, inflamed; burn and sting. Conjunctiva bright red, puffy. Lachrymation hot. Photophobia. Sudden piercing pains. Pain around orbits. Serous exudation, oedema, and sharp pains. Suppurative inflammation of eyes. Keratitis with intense chemosis of ocular conjunctiva. Staphyloma of cornea following suppurative inflammation. Styes, also prevents their recurrence.
2- Pulsatilla Pratensis
Thick, profuse, yellow, bland discharges. Itching and burning in eyes. Profuse lacrimation and secretion of mucus. Lids inflamed, agglutinated. Styes. Veins of fundus oculi greatly enlarged. Ophthalmia neonatorum. Subacute conjunctivitis, with dyspepsia; worse, in warm room.
3- Aconitum Napellus
Eyes red and inflamed, with deep redness of the vessels, and intolerable pains. Profuse lacrimation. Heat and burning in the eyes, with pressive and shooting pains, especially on moving the balls. Swelling of the eyes.
Dilated pupils. Lids feel dry, hard, heavy; sensitive to air. Red, hard swelling of the lids. Eyes sparkling, convulsed, and prominent. Look fixed. Cannot bear the reflection of the sun from the snow; it causes specks, sparks, and scintillations to dance before the eyes. Photophobia or sometimes strong desire for light. Black spots and mist before the eyes. Disturbed by flickering; fears he may touch others passing by.
Vision as if through a veil; difficult to distinguish faces; with anxiety and vertigo. Sudden attacks of blindness. A sensation of drawing in the eyelids with drowsiness. Ophthalmia, very painful, with blear eyedness, or from foreign bodies having come into the eyes (dust, sparks); from operations.
4- Mercurius Solubilis and Eyeballs Burning
Lids red, thick, swollen. Profuse, burning, acrid discharge. Floating black spots. After exposure to glare of fire; foundrymen. Parenchymatous keratitis of syphilitic origin with burning pain. Iritis, with hypopyon.
5- Arsenicum Album and Eyeballs Burning
Burning in eyes, with acrid lachrymation. Lids red, ulcerated, scabby, scaly, granulated. Oedema around eyes. External inflammation, with extreme painfulness; burning, hot, and excoriating lachrymation. Corneal ulceration. Intense photophobia; better external warmth. Ciliary neuralgia, with fine burning pain.
6- Allium Cepa and Eyeballs Burning
Red eyes. severe burning and smarting lachrymation. Sensitive to light (photophobia). Eyes suffused and watery; profuse, bland lachrymation, better in open air. Burning in eyelids.
7- Phosphorus
Cataract. Sensation as if everything were covered with a mist or veil, or dust, or something pulled tightly over eyes. Black points seem to float before the eyes. Patient sees better by shading eyes with hand. Fatigue of eyes and head even without much use of eyes. Green halo about the candlelight. Letters appear red. Atrophy of optic nerve.
Oedema of lids and about e eyes. Pearly white conjunctiva and long curved lashes. Partial loss of vision from abuse of tobacco, Pain in orbital bones. Paresis of extrinsic muscles. Diplopia, due to deviation of the visual axis. Amaurosis from sexual excess. Glaucoma. Thrombosis of retinal vessels and degenerative changes in retinal cells. Degenerative changes where soreness and curved lines are seen in old people. Retinal trouble with lights and hallucination of vision.
8- Euphrasia Officinalis and Eyeballs Burning
Catarrhal conjunctivitis; discharge of acrid matter. The eyes lacrimation all the time. Acrid lachrymation; bland coryza. Discharge thick and excoriating. Burning and swelling of the lids. Frequent inclination to blink. Free discharge of acrid matter. Sticky mucus on cornea; must wink to remove it. Pressure in eyes. Little blisters on cornea. Opacities. Rheumatic iritis. Ptosis.
9- Calcarea Carbonica
Sensitive to light. Lachrymation in open air and early in morning. Spots and ulcers on cornea. Lachrymal ducts closed from exposure to cold. Easy fatigue of eyes. Far sighted. Itching of lids, swollen, scurfy. Chronic dilatation of pupils. Cataract. Dimness of vision, as if looking through a mist. Lachrymal fistula; scrofulous ophthalmia.
10- Rhuta Grevinalis and Eyeballs Burning
Eyes strain followed by headache. Eyes red, hot, and painful from sewing or reading fine print. Disturbances of accommodation. Weary pain while reading. Pressure deep in orbits. Tarsal cartilage feels bruised. Pressure over eyebrow. Asthenopia.
11- Sulphur
Burning ulceration of margin of lids. Halo around lamp-light. Heat and burning in eyes (Ars; Bell). Black motes before eyes. First stage of ulceration of cornea. Chronic ophthalmia, with much burning and itching. Parenchymatous keratitis. Cornea like ground glass.
12- Belladonna and Eyeballs Burning
Throbbing deep in eyes on lying down. Pupils dilated (Agnus Castus). Eyes feel swollen and protruding, staring, brilliant; conjunctiva red; dry, burning; photophobia; shooting in eyes. Exophthalmos. Ocular illusions; fiery appearance. Diplopia, squinting, spasms of lids. Sensation as if eyes were half closed. Eyelids swollen. Fundus congested.
13- Argentum Nitricum
Inner canthal swollen and red. Spots before the vision. Blurred vision. Photophobia in warm room. Purulent ophthalmia. Great swelling of conjunctiva; discharge abundant and purulent. Chronic ulceration of margin of lids; sore, thick, swollen. Unable to keep eyes fixed steadily. Eye-strain from sewing; worse in warm room. Aching, tired feeling in eyes, better closing or pressing upon them. Useful in restoring power to the weakened ciliary muscles. Paretic condition of ciliary muscle. Acute granular conjunctivitis. Cornea opaque. Corneal ulcers.
14- Syphilinum
Chronic, recurrent, phlyctenular inflammation of cornea; successive crops of phlyctenular and abrasions of epithelial layer of cornea; photophobia intense, lachrymation profuse. Lids swollen; pain intense at night; ptosis. Tuberculous iritis. Diplopia; one image seen below the other. Feeling of cold air blowing on eye (Fluor ac).
15- Nux Vomica
Photophobia; much worse in morning. Smarting dry sensation in inner canthi. Infraorbital neuralgia, with watering of eyes. Optic nerve atrophy, from habitual use of intoxicants. Paresis of ocular muscles; worse, tobacco and stimulants. Orbital twitching radiating towards the occiput, Optic neuritis.
16- Gelsemium Sempervirens
Ptosis; eyelids heavy; patient can hardly open them. Double vision. Disturbed muscular apparatus. Corrects blurring and discomfort in eyes even after accurately adjusted glasses. Vision blurred, smoky. Dim-sighted; pupils dilated and insensible to light. Orbital neuralgia, with contraction and twitching of muscles. Bruised pain back of the orbits. One pupil dilated, the other contracted. Deep inflammations, with haziness of vitreous. Serous inflammations. Albuminuric retinitis. Detached retina, glaucoma and descemetitis. Hysterical amblyopia.
17- Cyclamen Europaeum
Dim vision, worse on waking, with spots before eyes. Flickering of various colors. Convergent strabismus. Sees countless stars. Diplopia. Disturbance of vision, associated with gastric disturbances.
Precautions
Education on proper care, treatment, and cleansing of contact lenses may help to treat Giant papillary conjunctivitis. Proper lens cleaning tips include:
- Use preservative-free cleaning solutions.
- Clean lenses thoroughly every time you take them out.
- Always rinse and store contact in fresh, clean disinfecting solution.
- If you have Giant papillary conjunctivitis, sterilizing your contacts with contact lens solution containing hydrogen peroxide works well.
- Clean with a proteolytic enzyme at least once per week.
- Replace your contact lenses regularly.
- Change the type or design of your lenses to help lower or remove the risk. One can do this by wearing daily disposable contact lenses or by using rigid gas-permeable (RGP) lenses instead of soft lenses.
Use prescribed eye drops
In some cases, D Eye drops may be prescribed to apply while wearing your contacts.
Possible complications
If left untreated, giant papillary conjunctivitis can cause damage to the eye. The bumps on the underside of the eyelid cause damage by rubbing the surface of the eye. This rubbing can damage the cornea and the result could be blindness.
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Dr. Sayyad Qaisar Ahmed (MD {Ukraine}, DHMS) ; senior research officer Dnepropetrovsk state medical academy Ukraine; is a leading Homeopathic physician practicing in Al-Haytham clinic, Umer Farooq Chowk Risalpur Sadder (0923631023, 03119884588), K.P.K, Pakistan.
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