The accompanying symptoms
Symptoms that accompany papilla excavation depend on the underlying cause. Since most optic disc changes are caused by glaucoma, these symptoms should be given priority. For example, an acute glaucoma attack is often accompanied by sudden headache and eye pain.
The affected eye may redden and vision may be impaired. The pupil may also be altered (for example, it may be slightly dilated and rounded). Occasionally, symptoms such as vomiting, nausea and dizziness may also occur due to the increased pressure.Chronic glaucoma is usually accompanied only by unspecific symptoms such as burning of the eye and headaches.
Visual field failures can also occur, these are usually small at first and progress slowly so that they are often not noticed immediately. Even if the optic disc excavation is not caused by glaucoma, visual disturbances usually occur as accompanying symptoms. Headaches, dizziness, and reddening of the eye are also common with papilla excavation. The symptoms of glaucoma?
The diagnosis
The diagnosis of a papilla excavation begins with a medical history, i.e. the interview of the affected person. Frequently, visual disturbances or other complaints of the eye are the cause of the doctor’s visit. In the case of an acute glaucoma attack as the cause of papilla excavation, symptoms such as a very hard to feel eyeball or a reddened eye may also occur.
If a papilla excavation is suspected, an ophthalmoscopy should be performed afterwards. This is a reflection of the back of the eye, which can also be used to view the optic nerve papilla. The change in the shape of the papilla can be recognized particularly well by the course of the blood vessels. If glaucoma is suspected, the intraocular pressure can also be measured. An examination of the visual field can also provide further information.
The treatment
The treatment of papilla excavation depends on its cause. The most common cause of optic disc excavation is glaucoma. When treating glaucoma, a distinction must be made between acute (emergency) glaucoma and chronically elevated intraocular pressure.
Acute glaucoma must be treated as soon as possible. The treatment consists of a drug-based lowering of the intraocular pressure, a reduction of the new production of aqueous humor and an exposure of the blocked chamber angle. If necessary – if a drug therapy is not sufficient – the chamber angle must be surgically exposed so that fluid can flow out of the eye again.
In chronic glaucoma, the eye pressure is usually adjusted with medication. Inflammatory causes of papilla excavation are often treated with painkillers that also have an anti-inflammatory effect. Cortisone can also be used in the therapy of inflammatory eye diseases, and if necessary, drugs that down-regulate the immune system may also have to be used. If a pathogen plays a role in an infectious eye disease, antibiotics or medication against certain eye viruses can also be used.
