A long-term soft contact lens wearer reports increasing lens awareness, mucus discharge, and reduced wearing time over three months. Examination reveals large papillae exceeding 1 mm on the superior tarsal conjunctiva. The FIRST step in management is:
- A Discontinue lens wear temporarily, then refit with a different lens material or replacement schedule ✓
- B Switch to daily disposable lenses immediately and continue full-time wear
- C Start topical corticosteroid drops four times daily and continue current lenses
- D Perform superior tarsal conjunctival biopsy
Correct answer: A. Discontinue lens wear temporarily, then refit with a different lens material or replacement schedule
Explanation
Giant papillary conjunctivitis is a mechanical and immunologic reaction to deposited lens material. Lens discontinuation allows the papillary reaction to settle, and successful refitting requires changing the replacement frequency or material, typically to daily disposables once inflammation has resolved. Prolonged steroids are avoided because of infection and pressure risk, and biopsy is unnecessary since the tarsal location and papillary morphology are diagnostic.
Reference: Yanoff and Duker Ophthalmology, 5th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.