Papillary excavation

La papillary excavation is a condition that occurs when the channel through which the optic nerve fibers exit is larger than the minimum space required. All healthy eyes have a mild degree of papillary cupping that is considered completely normal.

The problem occurs when some eye condition causes increase the size of the excavation making it one third the total size of the papilla.

To determine the cause of an abnormal papillary cup, it is necessary to perform an advanced study of the fundus and Intraocular pressure.

Papillary excavation

La papillary excavation is a condition that occurs when the channel through which the optic nerve fibers exit is larger than the minimum space required. All healthy eyes have a mild degree of papillary cupping that is considered completely normal.

The problem occurs when some eye condition causes increase the size of the excavation making it one third the total size of the papilla. 

To determine the cause of an abnormal papillary cup, it is necessary to perform an advanced study of the fundus and Intraocular pressure.

What is papillary cupping?

Papillary cupping is a symptom what is associated mainly al glaucoma. It is a physiological depression that occurs when the canal through which the optic nerve fibers exit is larger than normal.

All healthy eyes have some papillary excavation, even some more than others.

For people with glaucoma, the papillary cupping may increase to the point that exceeds one-third the size of the papilla, then is when we can say that presents pathology, usually indicating the presence of glaucoma

What is glaucoma?

Glaucoma is a set of conditions of the eyeball that increases intraocular pressure and significantly affects the functioning of the optic nerve.

Glaucoma is a condition associated with a failure of the eye's fluid drainage system, better known as aqueous humor.

The accumulation of fluid increases intraocular pressure and progressively impairs the functioning of the optic nerve until it causes vision loss.

In its initial phase, glaucoma is asymptomatic.

As the intraocular pressure increases considerably, symptoms may vary depending on the type of glaucoma that the patient presents.

The most common symptoms of glaucoma are:

papillary excavation

Eye with papillary cup

  • Mild changes in peripheral vision that are sometimes not noticeable by the person, but may be apparent on a medical eye exam.
  • Blurry vision.
  • Nausea and vomiting.
  • Headache and pain around the eyeball.
  • Progressive vision loss.
  • Abrupt vision loss.
  • See halos of colored light around the spotlights.

How do I know if I have glaucoma?

To find out if a person has a Papillary excavation due to glaucoma requires retinography. This test is currently one of the most advanced to study, in detail, the fundus of the eye.

When making a retinography, the ophthalmologist obtains a series of photographs that show pictures ampretinal bundles, the macula, the papilla, Optical disc...

Retinography can offer images as a whole or detailed images of a particular area in order to diagnose depressions, masses, lesions and anomalies.

When the retinography shows the presence of a papillary cup, usually the patient's diagnosis is glaucoma.

Other tests that help diagnose glaucoma are:

  • Tonometry to measure the intraocular pressure of the eye.
  • Gonioscopy to study the angle of drainage of the eye.
  • Ophthalmoscopy to study the state of the optic nerve.
  • Peripheral and side vision exam to detect blind spots in vision that the patient does not perceive.

All tests to detect glaucoma should be performed once a year from the age of 40 in order to diagnose this condition early and prevent total vision loss.

Types of papillae

Know identify the different types of papillae that they exist is important when examining the fundus of a patient's eye.

Papillae are classified as follows:

Healthy papilla 

In this type of papilla, the papillary cup is equal to or less than 0,3 and does not represent a difference between the two eyes greater than 0,2.

Hypermetropic papilla

They are smaller in size than healthy papillae and contain a greater number of blood vessels.

Myopic papilla

They have a larger papillary cup than healthy papillae, especially if the patient suffers from myopia and exceeds 6 diopters.

glaucomatous papillary cup

Oblique papilla

It is a congenital anomaly in which the nerve has a non-centered position with respect to the eyeball. They are so named because the papilla is oval in shape.

Papilla with large cup 

It is a papilla with increased excavation, usually greater than 0,3. However, the presence of this papilla in the eye does not necessarily imply the presence of eye disease.

Glaucomatous papilla

These are the papillae that most patients suffering from glaucoma have and that present an increased paiplar cup.

If glaucoma is not treated, the size of the excavation can gradually increase.

How to identify a healthy papilla from a pathological one?

When a patient presents with papillary excavation, they may experience certain symptoms that can serve as a guide for the medical specialist.

These symptom are:

  • Distorted vision.
  • See colored rings around the light bulbs.
  • Pain when moving eyes.
  • Temporary loss of vision.
  • Headache.
  • Color variations. 

In addition to ophthalmoscopy and retinography, it is necessary to do other tests such as campimetry, color tests, contrast sensitivity tests and tests pupillary reflexes.

These studies will be key in the diagnosis of a pathological papilla

When the ophthalmologist studies the structure of the optic nerve, he should pay attention to those changes that indicate that there is presence of papillary cup, Tales como el color, crafts y size from the excavation, bilateral symmetry, vascular area, peripapillary signs and neuroretinal rim shape.

Studying the papillary cup is necessary to detect the presence of glaucoma and avoid major complications.

Summary
What is papillary excavation and why does it occur?
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What is papillary excavation and why does it occur?
Description
Papillary excavation is a symptom that is usually associated with glaucoma, for this reason it is important to carry out a study when detecting symptoms.
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Área Oftalmológica Avanzada
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