Filtering bleb-induced giant papillary conjunctivitis

Abstract 

Background

Pathogenesis of giant papillary conjunctivitis is still elusive and many hypotheses are being proposed to explain the irritative symptoms associated with it. The research data available to date shows that mechanical, immunological and allergic components are involved in this to various extents. We report a rare cause of giant papillary conjunctivitis which was induced by a large filtering bleb following trabeculectomy surgery for glaucoma.

Method

A 30-year-old female, operated for glaucoma filtering surgery in her right eye 15 years back, presented with ocular irritation. Clinical evaluation revealed two giant papillae on the superior tarsal conjunctiva which coincided with the large filtering bleb with its peripheral extension. The fellow eye was normal and no association with any allergic disorders was noted.

Result

The patient responded symptomatically to the topical application of anti-inflammatory and anti-allergic medications. The giant papillae decreased considerably in size but the diffuse papillary response persisted.

Conclusion

Though multiple etiological factors have been proposed for the giant papillary conjunctivitis, only a single case report is available where a filtering bleb is the causative factor. The mechanical irritation caused by the large-sized bleb seems to be the provoking agent in our case taking into consideration the position of the papillae that coincides with the peripheral extension of the bleb.

Keywords: Giant papillary conjunctivitis, Filtering bleb, Olopatadine