MCQ – 87702

 A female patient, 18 years old, who is a contact lens wearer since two years, is complaining of redness, lacrimation and foreign body sensation of both eyes. On examination, visual acuity was 6/6 with negative fluorescein test. What is the expected diagnosis?

Correct Answer � B Explanation

Answer: B. Giant Papillary Conjunctivitis

Explanation: This is a case of Giant Papillary Conjunctivitis classically seen in contact lens wearers.

Predisposing factors

• Commoner in soft compared to rigid lenses occurs in silicone hydrogel, as well as hydrogel, lens wearers

• Lens deposits

• Thick or poorly designed or manufactured lens edges

• Meibomian gland dysfunction

• Atopy

Symptoms

• Almost always bilateral

• Upper tarsal conjunctiva (lower usually not affected)

• papillae-macropapillae (diameter between 0.3 and 1 mm) or giant papillae (diameter > 1 mm)

• hyperaemia

• stringy mucus in tear film and on conjunctival surfaces

• conjunctival oedema

Management

• Reduce exposure time

• abandon extended wear

• reduce daily wearing time to minimum possible

• cease wear for a period in some cases

• Optimise lens fit, material and wearing regime

• Topical mast cell stabilisers sodium cromoglicate 2%,  lodoxamide 0.1%, nedocromil sodium 2%

Topical combined anti-histamine/mast cell stabilizer olopatadine 0.1%