Allergic conjunctivitis in contact lens wearers: challenges and management recommendations

ABSTRACT

Introduction

Giant papillary conjunctivitis (GPC), which is the most severe type of contact lens–induced (CL) papillary conjunctivitis (CLPC), is an inflammatory condition of the upper tarsal conjunctiva. Major symptoms of CLPC include irritation, pain, itching, and redness of the ocular surface.

Area covered

This review provides an update on our current understanding of the pathogenesis and treatment of GPC.

Expert opinion

GPC is most often associated with the use of non-disposable soft contact lenses (SCL), or soft hydrogel lenses, and infrequent CL replacement. Patients with GPC may require both temporary cessation of CL wear and treatment with medications such as topical mast cell stabilizers, antihistamines, non-steroidal anti-inflammatory agents, or steroids.

KEYWORDS:

• Review
• allergic conjunctivitis
• contact lens
• giant papillae

Article highlights

• Allergic conjunctivitis induced by contact lenses (CLs) is less frequent in hard CL (HCL) users than in soft contact lens (SCL) users.

• Giant papillary conjunctivitis (GPC) is most often associated with the use of non-disposable SCL, or soft hydrogel lenses, and infrequent CL replacement.

• GPC is most commonly triggered by CL wear, but may occur in other situations: corneal foreign body, exposed sutures, exposed scleral buckles, ocular prosthetics, glaucoma filtration blebs, and band keratopathy.

• SCL disinfectant solutions include povidone-iodine, multi-purpose solutions using chemical disinfectants, and hydrogen peroxide-based solutions.

• Patients with GPC should first temporarily discontinue CL wear.

• Treatment of GPC involves the use of drugs such as topical mast cell stabilizers, antihistamines, non-steroidal anti-inflammatory agents, or steroids.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This work was supported by a Grant-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology of Japan [grant number 20H04347] and the Alcon Foundation (Grant 2019) to T Mimura.