Conjunctival papillary hyperplasia is a localized lesion of the conjunctiva caused by a large proliferation of conjunctival epithelial cells accompanied by vascular hyperplasia and infiltration of inflammatory cells, which is punctate or bulbous, and the surface of the conjunctiva is fluffy and non-smooth under the naked eye, and umbrella neovascularization can be seen in the central part of the papilla under the slit-lamp biomicroscope, which makes the papilla red. So how to diagnose conjunctival papillary hyperplasia? Conjunctival papillary hyperplasia is a non-specific sign of conjunctival inflammation and can be located in the lid conjunctiva or corneal limbus, presenting as an elevated, polygonal mosaic-like appearance, with areas of congestion separated by pale sulci. A central vessel is visible within each papilla on slit lamp and spreads out in a spoke-like pattern over the surface of the papilla. The papillae are actually conjunctival swellings resulting from exudate originating from the central vessel and infiltration of inflammatory cells, primarily polymorphonuclear leukocytes. Histologically, tiny connective tissue compartments anchoring the conjunctival epithelium to its underlying tissue play an important role in the formation of the papillae, and these connective tissue compartments limit the size of the papillae to less than lmm. These anchoring septa become less frequent as they reach the upper lid margin, so that when the upper lid is turned, the conjunctiva at the upper lid margin may appear wavy, resembling a giant papilla or follicle, but in fact, this may be a normal phenomenon, so it is inappropriate to use the upper lid margin area to analyze the clinical signs of a papilla or follicle. Trachoma is often associated with significant papillary hyperplasia. The formation of giant papillae is due to the disintegration and rupture of the tiny connective tissue septa that play an anchoring role. The diameter of giant papillae is greater than lmm , which mostly occurs in the conjunctiva of the upper eyelid, and it is common to see spring Catarrhal Conjunctivitis and Contact Lens Giant Papillary Conjunctivitis. Examination reveals redness and swelling of the eyelids, lid conjunctival congestion, papillary follicular hyperplasia, peripheral congestion of the bulbar conjunctiva, sometimes edema and subconjunctival hemorrhage, and secretions in the conjunctival sac. To determine the source of the disease, it is necessary to make secretion smears for bacterial and cytologic examination. 1, if necessary, conjunctival epithelial scraping and secretion smear or culture to check bacteria, fungi, isolation of viruses, etc., and drug sensitivity test. 2.If there are irritation symptoms, the cornea should be examined by fluorescein staining. 3.If necessary, epidemiologic investigation should be carried out. 4, for chronic conjunctivitis should be asked: there is no refractive error, excessive smoking, alcohol, sleep deprivation or long-term exposure to wind, sand, smoke and dust and other medical history. Examine nearby tissues for chronic inflammation, such as chronic dacryocystitis.