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complete discontinuation of contact lenses or ocular prosthetics may be met with some degree of resistance from patients. Fortunately, contact lens wear does not need to be completely discontinued to minimize the symptoms of GPC. Significant reduction in the signs and symp- toms may be achieved by changing the contact lens material and care routine. Disinfecting solutions that contain chemical preservatives should be discontinued. Converting a patient from soft daily-wear contact lenses to disposable or daily-disposable soft contact lenses may prevent the accumulation of proteinaceous deposits, which may be the antigenic stimulus for

GPC. [16] Rigid gas permeable contact lenses may provide further relief from symptoms if disposable lenses do not provide an adequate response. This relief is obtained because of the decreased proclivity of the rigid gas permeable contact lenses to develop adherent deposits and coatings. Pharmacologic treatment of GPC includes the use of mast cell stabilisers, topical corticosteroids, and antihistamines similar to that in the other immunologic conjunctival disorders discussed previously. As always, care must be taken when using topical corticostero- ids; a pulsed regimen is recommended to minimise adverse reactions.


    • 1.

      Calder V.L., Lackie P.M.: Basic science and pathophysiology of ocular allergy. Curr Allergy Asthma Rep, 4(4):326 –31 (2004)

    • 2.

      Bielory L.: Allergic and immunologic disorders of the eye. Part II: Ocular allergy. J Allergy Clin Immunol. 106:1019 –1032 (2000)

    • 3.

      Davies R.J., Rusznak C., Devalia J.L.: Why is allergy increasing? Environmental factors. Clin Exp Allergy, 28:8–14 (1998)

    • 4.

      Bonini Se., Bonini St.: Heterogeneity of allergic inflammatory disease of the external eye. In: Oehling

      • A.

        K., Huerta Lopez J.G: Progress in Allergy and Clinical Immunology Vol. 4. Hogrefe and Huber Publishers, Cancun, pp. 372–377 (1997)

    • 5.

      Donshik P.C., Ehlers W.H.: Ocular allergy. In: Smolin G & Thoft R (ed), The Cornea. Little, Brown and company, 347–368 (1994)

    • 6.

      Schmid K.L., Schmid L.: Ocular allergy: causes and therapeutic options. Clinical and Experimental Optometery, 83.5 (2000)

    • 7.

      Leonardi A.: Emerging drugs for ocular allergy. Expert Opin Emerg Drugs, 10(3):505–20 (2005)

    • 8.

      Nichols J., Snyder R.W.: Topical nonsteroidal anti-inflammatory agents in ophthalmology. Curr Opin Ophthalmol, 9(4):40–4 (1998)

    • 9.

      Ilyas H., Slonim C.B., Braswell G.R., Favetta J.R., Schulman M.: Long-term safety of loteprednol eta- bonate 0.2% in the treatment of seasonal and perennial allergic conjunctivitis. Eye Contact Lens, 30(1):10 –3 (2004)

  • 10.

    BenEzra D., Pe’er J., Brodsky M., Cohen E.: Cyclosporine eyedrops for the treatment of severe vernal keratoconjunctivitis. Am J Ophthalmol, 101(3):278–82 (1986)

  • 11.

    Bleik J.H., Tabbara K.F.: Topical cyclosporine in vernal keratoconjunctivitis. Ophthalmology, 98(11):1679 –84 (1991)

  • 12.

    Daniell M., Constantinou M., Vu H.T., Taylor H.R.: Randomised controlled trial of topical cyclosporin A in steroid dependent allergic conjunctivitis. Br J Ophthalmol, 90(4):461–4 (2006)

  • 13.

    Durham S.R., Walker J.M., Varga E.M., et al.: Long term clinical efficacy of grass pollen immunothe- rapy. N Engl J Med 341:468 (1999)

  • 14.

    Abelson M.B., Butrus S.I., Weston J.H.: Aspirin therapy in vernal conjunctivitis. Am J Ophthalmol, 95(4):502–5 (1983)



  • 15.

    Hoang-Xuan T., Prisant O., Hannouche D., Robin H.: Systemic cyclosporine A in severe atopic kera- toconjunctivitis. Ophthalmology, 104(8): 1300–5 (1997)

  • 16.

    Porazinski A.D., Donshik P.C.: Giant papillary conjunctivitis in frequent replacement contact lens wearers: a retrospective study. CLAO J, 25(3):142–7 (1999)


  • -

    Bartlett J.D., Jaanus S.D.: Clinical ocular pharmacology. 3rd ed. Boston: Butterworth-Heinemann, (1995)

  • -

    Palmares J., Delgado L.: Ocular allergy. Portugal: Medisa (1997)

  • -

    Koevary S.B.: Ocular immunology in health and disease. Boston: Butterworth-Heinemann, (1999)

  • -

    Lockey R.F., Bukantz S.C.: Allergens and allergen immunotherapy. 2nd ed. New York: Marcel Dekker


  • -

    Donshik P.C., Ehlers W.H.: Ocular allergy. In: Smolin G & Thoft R (ed), The Cornea. Little, Brown and com-

pany, 347–368 (1994)



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