To the Editor.
—Giant papillary conjunctivitis (GPC) is an inflammatory condition characterized by large papillary excrescences of the upper tarsal conjunctiva.1 It has been associated with the wearing of soft and rigid contact lenses, which is often discontinued because of ocular discomfort. Recently, however, certain measures have been suggested that seem to restore contact lens tolerance. These include improved lens handling and hygiene, switching or replacing lenses, and the topical application of cromolyn.2,3 While it appears that these therapeutic maneuvers lessen the symptoms and perhaps the signs of GPC in some patients, it is possible that the underlying inflammatory process may be allowed to continue in a contact lens wearer whose symptoms are masked or minimized by these maneuvers.White subepithelial changes of the upper tarsal conjunctiva have been observed in patients with GPC.1 These occur to a varying extent. They are found at the apexes of
Meisler DM, Udell IJ, Stock EL, Lass JH. Caution Regarding Treatment of Giant Papillary Conjunctivitis. Arch Ophthalmol. 1986;104(11):1588. doi:10.1001/archopht.1986.01050230026018