What is a Papillomacular Bundle?
The papillomacular bundle is the bundle of nerves in the retina that connects the macula and the optic nerve. The macula is the part of the eye responsible for central vision and clear, detailed “20/20” vision. The optic nerve is the structure that sends light information from the eye to the brain, so that the brain can make sense of the images that we see.
The nerve fibers of the papillomacular bundle send visual information from the macula (central retina) to the optic nerve. The papillomacular bundle is made from ganglion cells, a type of neuron that carries electrical impulses. Damage to the papillomacular bundle can cause blind spots, or dark black spots, in the center of the vision. Conditions that can damage the papillomacular bundle include glaucoma, disease of the optic nerve, or toxins such as alcohol or tobacco.
Key Takeaways
- The papillomacular bundle is a bundle of nerves that carries visual information from the macula to the optic nerve, so that our brains can interpret what our eyes see.
- Damage to the papillomacular bundle can cause blind spots in the center of the vision.
- Conditions that can damage the papillomacular bundle include glaucoma, alcohol or tobacco, or medications such as ethambutol.
Understanding Papillomacular Bundle
The papillomacular bundle is made up of nerves. The nerves, known as ganglion cells, transmit light information from the retina to the brain. The nerves in the papillomacular bundle connect to the macula, which is responsible for high-resolution central vision. Because a large majority of visual information from the macula is sent to the papillomacular bundle, it is important for this bundle to be healthy and well-functioning to allow for sharp, clear vision.
Papillomacular Bundle Damage
Papillomacular bundle damage can occur due to systemic diseases, retinal diseases, or toxicity. If the papillomacular bundle becomes damaged, it can cause vision loss, a blind spot in the central vision, and changes in the way you see colors. Causes of papillomacular bundle damage include:
- Glaucoma
- Uncontrolled diabetes
- Uncontrolled hypertension (high blood pressure)
- Chronic alcohol abuse
- Tobacco
- Medication toxicity, such as from ethambutol
- Carbon monoxide poisoning
- Heavy metal poisoning from lead, mercury, or thallium
Having high blood pressure or diabetes can cause damage to the papillomacular bundle. In people with poorly controlled diabetes and hypertension, the blood vessels and nerves throughout the body get damaged. The lack of blood supply to the papillomacular bundle can cause sudden vision loss.
Papillomacular Bundle Loss
Clinical signs of papillomacular bundle loss include:
- A pale/white appearing optic nerve
- White appearance of outer retina due to tissue death
- Thinning of optic nerve
- A blind spot in the vision
- Decreased peripheral vision
- New blood vessel growth in the retina
Papillomacular Bundle Glaucoma
Glaucoma is an eye condition that is characterized by progressive, irreversible optic nerve damage and loss of vision. Patients with glaucoma may or may not have increased eye pressure. The optic nerve is a structure in the back of the eye that connects the eye to the brain. Glaucoma progresses very slowly, over the course of many years. The papillomacular bundle, the bundle of nerve fibers that extends from the macula to the temporal part of the optic nerve, is one of the first locations of glaucoma damage.
Glaucoma causes the papillomacular bundle to get thinner over time. People with glaucoma usually do not have any symptoms until the glaucoma is severe. Mild glaucoma can only be detected by getting an eye exam with an eye doctor. When glaucoma is severe enough that the vision is affected, it is often too late to undo the damage to the vision. Severe glaucoma causes “tunnel vision.” Glaucoma should be identified as early as possible so that treatment can be started. If left untreated, glaucoma can lead to permanent blindness.
