Date of last review: Due to be updated

Differential diagnosis

  • Vernal Keratoconjunctivitis
  • Atopic Keratoconjunctivitis
  • Seasonal Allergic Conjunctivitis
  • Superior Limbic Keratoconjunctivitis

Possible management by Optometrist

Treatment

  • Cease contact lens wear for 2-4 weeks
  • If very symptomatic consider
    • PoM Olopatadine 1 drop twice daily (8 hourly interval) if very symptomatic
      • Contraindicated in
        • breastfeeding/pregnancy
        • women of childbearing age not using contraception
      • then PoM Fluorometholone 0.1% eye drops 4x daily (reduce by 1 drop a week to zero)
    • Where recurrent and continued contact lens use is required consider
      • Preservative free sodium cromoglicate 2% eye drops 4 times daily

Advice

  • Giant papillary conjunctivitis appears to be an allergic response related to trauma to the conjunctiva lining the eyelid
    • Contact lens (especially soft)
    • Protruding sutures/scleral buckles/filtration blebs
    • Elevated corneal deposits
  • Reduce daily wearing time to a minimum
  • Optimise lens fit
  • Optimise cleaning regime
  • If using soft lenses switch to daily disposable

Management Category

  • Normally no referral

Possible management by Ophthalmologist

  • Topical Steroids
  • Removal of protruding sutures