The local case of CLPC indicates that
practitioners should be alert to any of the
symptoms of CLPC, even in the absence
of clinical signs. Patients who experience
symptoms should be managed closely so
that if signs of CLPC become apparent,
appropriate changes to lens wear schedules
or cleaning regimens can be recommended.
Patients who develop general
CLPC should discontinue contact lens
wear until all symptoms have subsided and
papillae have decreased in intensity. Because
of the severity of the response, these
patients should be strongly advised to
resume lens wear on a daily disposable
schedule (one day disposable lenses) to
minimise any possible mechanicallyinduced
conjunctival trauma and/or
accumulation of contact lens
Patients with acute local CLPC who are
keen to continue extended wear can
change to a new lens of the same or different
type. Ifsigns and symptoms return, the
patient should change to a different lens
type with a daily disposable or frequent replacement
schedule (from one to three
weeks) as patients on frequent replacement
schedules may be at a lower risk of
developing CLPC.29*90
The local response of CLPC indicates
that mechanical trauma between the lens
and the superior palpebral conjunctiva
may play an important role in the development
of local CLPC. Although the incidence
of general and local CLPC in high
Dk silicone hydrogel lens wear has yet to
be determined, preliminary data suggests
that a greater proportion of patients wearing
high DK lenses during extended wear
develop local CLPC in comparison to patients
wearing conventional hydrogel
lenses.31
ACKNOWLEDGEMENTS
This work was partly funded by the Australian
Federal Government through the
Cooperative Research Centres Program
and CIBA Vision, Inc. The authors would
like to thank Senna Stretton for assistance
in the preparation of this manuscript and
i-media at CRCERT for the illustrations.