Giant papillary conjunctivitis (GPC) is a condition affecting the eye where small, round bumps — known as papillae — develop inside the eyelid, causing irritation and other symptoms.

GPC is a common complication associated with wearing contact lenses. However, other underlying causes, such as allergic reactions to other foreign bodies in the eye, can also lead to its development.

Regardless of the underlying cause, GPC is an allergic reaction that occurs on the inside of the eyelid.

This article reviews GPC in more detail, including its symptoms, causes, and more.

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GPC occurs when the inside of the eyelid becomes irritated, red, and swollen. It typically occurs due to the presence of a foreign body in the eye. As the disease advances, small, round papulae may develop.

Though the exact causes of giant papillary conjunctivitis are not well-understood, it may occur due to a reaction on the inside of the eyelid.

As such, some health experts may describe it as a type of allergic conjunctivitis. However, others state it is distinct from allergic conjunctivitis due to having a mechanical cause, such as something in the eye. It may also be possible to confuse GPC with vernal keratoconjunctivitis, a type of allergic conjunctivitis.

GPC is more likely to occur in people who:

  • wear hard contact lenses
  • wear soft contacts but do not replace them frequently
  • have a stitch on the surface of the eye
  • have a prosthetic eye

Symptoms of GPC may depend on the stage of the condition.

Early signs and symptoms can include the development of a rough, swollen, and irritated eyelid. As it progresses, small papulae may develop. These can grow in size over time.

A person may also notice additional symptoms related to GPC. These can include:

  • a droopy, swollen eyelid
  • the feeling of an object stuck in the eye
  • excessive eye mucus, which may make vision blurry
  • a sensation that the contact lens moves when blinking
  • itchy, painful, or red eyes

A person may also find it difficult to continue using contact lenses. An eye doctor will likely recommend that a person stop wearing contact lenses for a period of time following diagnosis.

Health experts will typically break GPC into early and advanced stages.

Early GPC is associated with irritated, red, and swollen eyes and eyelids. Symptoms may be generally mild and uncomfortable. At this stage, a person may find that stopping the use of contacts can help.

As it progresses, a person may develop one or more papulae on the inside of their eyelid. Symptoms often worsen as the papulae grow, which may include blurry vision and the inability to wear contact lenses.

The most common cause of GPC is wearing contact lenses. The condition can occur at any time, meaning that a person can wear contact lenses for years before it develops, or it could happen when they first start wearing them.

As well as stitches and the use of a prosthetic eye, other potential causes include allergies to lens cleaning solution or contacts themselves and deposits on the contact lenses.

Risk factors for developing GPC include:

  • use of nondisposable lenses
  • wearing contacts for a longer time
  • atopy, which is a genetic disposition to develop allergies
  • infrequent lens replacement
  • inadequate lens hygiene

Treating GPC can help cure the condition, eliminate symptoms, and prevent further complications.

Some common treatment options an eye doctor may suggest include:

  • limiting time in contacts each day
  • discontinuing contact lenses for a few weeks
  • changing contact lens type
  • using eye drop medication or ointment for swelling and itchiness
  • never sleeping while wearing contact lenses
  • avoiding lens solutions with preservatives

Often, stopping the use of contact lenses in the early stages is enough to reverse the condition. A doctor may also prescribe antihistamines or steroids.

Treatment duration may last for about 2–4 weeks. However, this is often the length of time on a short course of medications. In other cases, people may require medications for a longer amount of time. In most cases, the outlook is favorable.

In severe cases or ones where it does not respond to other treatments, an eye doctor may recommend surgery. A 2017 study notes that surgical excision of papillae can be an effective treatment option.

Left untreated, GPC can progress and worsen. Though some experts note that GPC can cause issues with the cornea if left untreated, others observe this complication is rare. If damage to the cornea occurs, it can affect a person’s vision.

Cornea-related complications can include superficial punctate keratitis, which is the death of cells on the surface of the cornea that causes watery, red eyes and light sensitivity.

Another possible complication includes shield ulcers, which occur on the cornea. This causes watery eyes, light sensitivity, and discharge from the eyes. However, this is very rare with GPC and more likely to occur with vernal keratoconjunctivitis.

In some cases, GPC can cause pseudoptosis. This is a non-neurological drooping of the eyelid.

Learn more about the treatment for droopy eyelids.

Typically, the most common complication with GPC is that individuals who do not receive prompt treatment are unable to wear contact lenses in the future due to discomfort.

Giant papillary conjunctivitis (GPC) is a condition that affects the inside of the eyelid. It causes redness, swelling, and irritation of the eyelids. As GPC progresses, a person may notice worsening symptoms that can include discharge, a feeling of something stuck in the eye, and an inability to wear contact lenses.

Experts do not fully understand the exact cause but note that it could be a type of allergic conjunctivitis. However, as it is often due to a foreign body irritating the eyelid, many instead suggest it is a nonallergic hypersensitivity disease and not a type of allergic conjunctivitis.

Regardless of the exact cause, GPC is more likely to occur in people who wear contact lenses, have an artificial eye, or have stitches on the surface of the eye.

Treatment can include stopping the use of contacts, the use of ointments or drops, and, in rare cases, surgery. Once treated, a person generally fully recovers.