A Guide to Clinical Contact Lens Management

Signs, Symptoms, Diagnosis and Management

Academy for Eyecare Excellence™
IN COOPERATION WITH
Centre for Contact Lens Research
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Differential Diagnosis:
Palpebral Conjunctival Inflammation


Hyperemia The palpebral conjunctiva is richly vascularized and mild insults may increase the blood flow. Often the first sign of inflammation.
Papillae Papillae are raised areas on the palpebral conjunctiva and have a central blood vessel. The presence of papillae on the upper tarsal conjunctiva >1.0mm diameter is indicative of giant papillary conjunctivitis or vernal keratoconjunctivitis.
Follicles Follicles are accumulations of white blood cells within the palpebral conjunctiva without a central blood vessel. Follicles accompany viral infections of the conjunctiva and are not CL-related.
Concretions Concretions are pale yellow accumulations of inorganic type material beneath the epithelium of the palpebral conjunctiva. They may cause a foreign body sensation. Not CL-related.

Refer to the individual conditions for the differential diagnosis conditions shown in the diagram below. Click on images to view enlargement.

Hyperemia - Palpebral Conjunctiva

Hyperemia – palpebral conjunctiva

Junctional Papillae (Normal)

Junctional papillae - normal

CLPC (Contact Lens Papillary Conjunctivitis)

CLPC

Video: Contact Lens Papillary Conjunctivitis (CLPC) -
Severe (White Light)

Contact Lens Papillary Conjunctivitis (CLPC) - Severe (White Light)

GPC (Giant Papillary Conjunctivitis)

GPC

Follicles

Follicles

Concretions

Concretions
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