This guideline last updated 06/05/2022 17:46:52

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