Photo Rounds

Eye irritation

A young man—who was a contact lens wearer—asked his family physician (FP) to look at his eye, which was irritated. The patient’s bulbar conjunctiva was not particularly red, so the physician flipped the upper lid to look for a foreign body.

What’s your diagnosis?


The FP recognized the follicular pattern as giant papillary conjunctivitis, secondary to contact lens use. This is an allergic phenomenon involving mast cells.

While there are many topical ophthalmic medications that can be used to treat this condition, the FP preferred to have an ophthalmologist evaluate the patient. In the meantime, he advised the patient to stop wearing his contact lenses.

Meticulous attention to contact lens cleaning and hygiene is important to prevent the development of giant papillary conjunctivitis.

Text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. Photo courtesy of Paul Comeau. This case was adapted from: Chumley H, Usatine R. Differential diagnosis of the red eye. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. Color Atlas of Family Medicine. 2nd ed. New York, NY: McGraw-Hill; 2013:163-168.

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