This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Inflammations of Conjunctiva - Allergic and Granulomatous, Subject name: Ophthalmology
Giant papillary conjunctivitis is caused by 
Select and explain. 
A. Contact lens, B. Trichiasis, C. LASIK, D. L.ASEK
A: Contact lens
Answer: A: Contact lens 
Explanation: Ans: A (Contact lens) Ref: Kanski clinical ophthalmology 6th edition; page 218, 234Explanation:Conjunctiva] papillae: Hyperplasic conjunctival epithelium with fibrovascular core and subepithelial infiltration with inflammatory cells.Three types of papillae:Micropapillae - mosaic like red dotsMacropapillae - < 1 mm in sizeGiant papillae - > I mm in sizeCauses of Giant Papillary ConjunctivitisRepeated mechanical irritation of the conjunctivaOcular prosthesesExtruding scleral bucklesExposed ocular suturesFiltering blebElevated corneal scars- Giant papillary conjunctivitis symptoms and signs, such as papillary changes in the tarsal conjunctiva, have been associated with the use of all types of contact lenses (eg. rigid, hydrogel, silicone hydrogel, piggyback, scleral, prosthetic).Incidence of giant papillary conjunctivitis with various types of contact lensesSoft contact lens wearers: 1% to 45%'Conventional soft contact lens: 34%Extended wear disposable soft contact lens wearers -5%Frequent replacement contact lens (every one day to twelve weeks): 21.27%Rigid gas permeable lens wearers: Very low (1 % to 5%).