Giant papillary conjunctivitis with ocular prostheses
B. D. Srinivasan, F. A. Jakobiec, T. Iwamoto and A. G. DeVoe
In seven patients who each had either a methyl methacrylate corneal shell,
a postenucleation ocular prosthesis, or a keratoprosthesis, giant papillary
conjunctivitis of the tarsus of the upper lids developed after prolonged
wear. These cases expand the spectrum of disease that was initally
described in wearers of hard and soft contact lenses. The papillary changes
in prostheses wearers did not always produce symptoms and were not readily
reversible. Basophils and mast cells characterized the inflammatory
infiltrate, suggestng an antigen-antibody mechanism underlying the
response. Increased production of epithelial mucin, in contrast to goblet
cell mucin, may play a role in producing symptoms in this syndrome.