Papilledema

Papilledema
Fundal photograph showing severe papilledema in the left eye
SpecialtyOphthalmology, optometry, neuro-ophthalmology, neurology, neurosurgery

Papilledema or papilloedema is optic disc swelling that is caused by increased intracranial pressure due to any cause.[1] The swelling is usually bilateral and can occur over a period of hours to weeks.[2] Unilateral presentation is extremely rare.

In intracranial hypertension, the optic disc swelling most commonly occurs bilaterally. When papilledema is found on fundoscopy, further evaluation is warranted because vision loss can result if the underlying condition is not treated.[1] Further evaluation with a CT scan or MRI of the brain and/or spine is usually done. Recent research has shown that point-of-care ultrasound can be used to measure optic nerve sheath diameter for detection of increased intracranial pressure and shows good diagnostic test accuracy compared to CT.[3] Thus, if there is a question of papilledema on fundoscopic examination or if the optic disc cannot be adequately visualized, ultrasound can be used to rapidly assess for increased intracranial pressure and help direct further evaluation and intervention. Unilateral papilledema can suggest a disease in the eye itself, such as an optic nerve glioma.

  1. ^ a b Blumenfeld, Hal (2022). Neuroanatomy through clinical cases (3rd ed.). Sunderland, Massachusetts: Sinauer Associates. p. 143. ISBN 978-1-60535-962-5.
  2. ^ K., Khurana, A. (2015). Comprehensive ophthalmology. Khurana, Aruj K., Khurana, Bhawna. (6th ed.). New Delhi: Jaypee, The Health Sciences Publisher. ISBN 9789351526575. OCLC 921241041.{{cite book}}: CS1 maint: multiple names: authors list (link)
  3. ^ Ohle, Robert; McIsaac, Sarah M.; Woo, Michael Y.; Perry, Jeffrey J. (2015-07-01). "Sonography of the Optic Nerve Sheath Diameter for Detection of Raised Intracranial Pressure Compared to Computed Tomography A Systematic Review and Meta-analysis". Journal of Ultrasound in Medicine. 34 (7): 1285–1294. doi:10.7863/ultra.34.7.1285. ISSN 0278-4297. PMID 26112632. S2CID 25301791.