Giant Papillary Conjunctivitis most commonly occurs when:

Giant Papillary Conjunctivitis (GPC) is an inflammatory reaction that is often associated with the use of contact lenses, particularly soft lenses. It is characterized by the formation of large papillae on the inner eyelid and is primarily caused by various factors including mechanical irritation, allergens, and the presence of deposits on contact lenses.

The correct choice reflects that lens hygiene plays a crucial role in the development of GPC. When lens hygiene is neglected, there is an accumulation of proteins, lipids, and other debris on the lens surface. This debris can lead to irritation of the conjunctiva as well as provoke an allergic reaction, contributing to the inflammation characteristic of GPC. Proper cleaning and disinfecting of contact lenses help prevent the buildup of these harmful deposits, thereby reducing the risk of GPC.

In contrast, while extended wear of contact lenses and improper storage can contribute to eye issues, they may not directly cause the specific inflammatory response seen in GPC in the same way that poor hygiene does. Cleaning lenses with a surfactant can help remove deposits but does not necessarily relate to the key factor of neglecting overall hygiene, which is critical for preventing conjunctival irritation and inflammation.