Contact lens-induced papillary conjunctivitis is associated with increased albumin deposits on extended wear hydrogel lenses.

Albumin surface deposits were significantly higher on contact lenses from subjects with CLPC (p<0.0001, Figure 5). m Lenses from six of the CLPC subjects were analysed prior to the event. There was no difference in the amount of HSA on these lenses compared to the CLPC lenses. m Lactoferrin amounts were not significantly different between the CLPC and non-CLPC groups (Figure 6). m The amount of sIgA was not significantly different between the CLPC and non-CLPC groups (Figure 7). n Results m Extended wear contact lenses from subjects with CLPC have significantly more albumin on their surface. m Deposits of sIgA and lactoferrin do not appear to be increased during CLPC. n Conclusions m Prospective studies to determine if increased albumin of the surface of contact lenses precedes clinical signs of CLPC. m To determine if other protein profiles on the lenses or in the tears of subjects with CLPC are altered. CLPC appears to be an immunological/mechanical response to contact lenses and their deposits (Figure 1), resulting in a hypersensitivity reaction. 1 Enlarged papillae on the tarsal conjunctiva, redness, itching, increased mucus and decreased contact lens tolerance are typical symptoms. 2 Contact lens papillary conjunctivitis (CLPC) is the major reason for discontinuation of contact lens wear. However its mechanism of action is still unclear. Figure 2 shows the conjunctiva of a subject without CLPC. Figures 3 and 4 show the conjuctiva of 2 subjects with CLPC. m Nitrocellulose discs spiked with known concentrations of each protein were used as standards. m Non-specific binding was calculated from unworn lenses. m Standards and lenses were blocked with either 0.2%Tween-20/PBS (PBST) or 3% BSA/PBST. m Standards and lenses were incubated with either α–human HSA, α–human sIgA or α–human lactoferrin peroxidase conjugated antibodies at 1/1000 in PBST. m ABTS peroxidase substrate was added for 10 mins with gentle agitation and the absorbance read at 405nm, from a 200µl aliquot. m Standard curves were determined and the lens absorbance values converted into absolute amounts of each protein. n Methods m Significant albumin deposits on contact lenses may be the end product of an inflammatory response cascade. Increased conjunctival permeability during CLPC has been suggested. 3,4,5,6 Deposits 6 and tear albumin levels 4 have also been shown to increase during CLPC. m The lack of difference in albumin deposits found before and during CLPC may indicate that those subjects who continue in contact lens wear …