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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.
Unilateral or bilateral optic disc edema may occur. The exact etiology, pathogenesis and mechanism of the disc edema is unknown. [ 1 ] [ 2 ] Theories suggest that the dis edema is due to retinal vascular leakage into and surrounding the optic nerve and disruption of axoplasmic flow resulting from microvascular disease of the optic nerve head. [ 2 ]
It is used to detect and evaluate symptoms of various retinal vascular diseases and eye diseases. In patients with headaches , the finding of swollen optic discs ( papilledema ) on ophthalmoscopy is a key sign indicating raised intracranial pressure , which may be due to conditions such as hydrocephalus , benign intracranial hypertension ...
If the papilledema has been longstanding, visual fields may be constricted and visual acuity may be decreased. Visual field testing by automated perimetry is recommended as other methods of testing may be less accurate. Longstanding papilledema leads to optic atrophy, in which the disc looks pale and visual loss tends to be advanced. [5] [9]
The more common features of the disease are summarized in the acronym POEMS: Papilledema (swelling of the optic disc) often but not always due to increased intracranial pressure) is the most common ocular sign of POEMS syndrome, occurring in ≥29% of cases.
Optic-disc edema of Grade 0-2; CSF opening pressure ≤ 25 cm H 2 O; Class 4 Institute treatment protocol as per Clinical Practice Guideline ≥ 0.50 diopter cycloplegic refractive changes and/or cotton-wool spot; Optic nerve sheath distention, and/or globe flattening and/or choroidal folds and/or scotoma; Optic-disc edema Grade 2 or above
Papilledema that is not yet chronic will not have as dramatic an effect on vision. Because increased intracranial pressure can cause both papilledema and a sixth nerve palsy, papilledema can be differentiated from papillitis if esotropia and loss of abduction are also present. However, esotropia may also develop secondarily in an eye that has ...
Papilledema: "The underlying mechanism for visual obscurations in all of these patients appear to be transient ischemia of the optic nerve head consequent to increased tissue pressure. Axonal swelling, intraneural masses, and increased influx of interstitial fluid may all contribute to increases in tissue pressure in the optic nerve head. The ...
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