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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]
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]
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 ...
4 Treatment. 5 History. 6 References. ... Symptoms: blurry vision, vision loss ... optic nerve head swelling (papilledema) and tortuosity of blood vessels. [1]
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.
disc edema in the contralateral eye central scotoma (loss of vision in the middle of the visual fields) in the ipsilateral eye The presence of anosmia (loss of smell) ipsilateral to the eye demonstrating optic atrophy was historically associated with this syndrome, but is now understood to not strictly be associated with all cases.
Cavernous sinus thrombosis, associated with infection of the paranasal sinuses, proptosis, periorbital oedema, retinal haemorrhages, papilledema, extraocular movement abnormalities, and trigeminal nerve sensory loss; Carotid-cavernous fistula – classic triad of chemosis, pulsatile proptosis, and ocular bruit; Cluster headache; Trichinellosis