A soft contact lens wearer using extended-wear lenses complains of increasing lens intolerance, mucus production, and itching. Examination shows giant papillae on the upper tarsal conjunctiva but no Horner-Trantas dots and no limbal involvement. First-line management is:

• A Start topical cyclosporine 0.05% twice daily indefinitely
• B Begin long-term topical steroid therapy with taper over one year
• C Discontinue contact lens wear and refit with daily disposable lenses after resolution ✓
• D Perform cryotherapy of the tarsal conjunctiva

Explanation

Giant papillary conjunctivitis is a mechanical and immunologic reaction to deposited material on the lens surface. The cornerstone of management is removing the inciting stimulus: stopping lens wear until inflammation subsides, improving hygiene, and refitting, ideally with daily disposable lenses. Steroids are reserved short-term for severe cases because of glaucoma and cataract risk with prolonged use. Cyclosporine and cryotherapy are measures for refractory vernal keratoconjunctivitis, not routine GPC management.

Reference: Parsons' Diseases of the Eye, 23rd ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.