Definition:
Papilloedema is a disease characterized by optic disc swelling, often as a result of increased intracranial pressure. The characteristic swelling frequently occurs bilaterally over a period of hours to weeks. Papilloedema is also alternatively spelled as papilledema.
Diagnosis:
If papilloedema is suspected, a physician will typically check the eyes for signs of papilloedema through an ophthalmoscopy or slit lamp examination. Diagnosis will usually be made on the following hallmark presentations: blurring of the disc margins; filling in of the optic disc cup; anterior bulging of the nerve head; edema of the nerve fiber layer; retinal or choroidal folds; congestion of retinal veins; peripapillary hemorrhages; hyperemia of the optic nerve head; nerve fiber layer infarcts; and hard exudates of the optic disc.
Treatment:
Treatment for papilloedema depends primarily on the underlying cause. In general, elevated intracranial pressure may be controlled with the use of acetazolamide, glucocorticoids, and, when necessary, surgical shunting.
Symptoms and Signs:
In initial stages, papilloedema typically does not cause symptoms. However, in its more severe form, papilloedema presents with: blurry vision; visual obscurations (such as an inability to see in a part of the visual field for a period of time); and even actual loss of vision.
Causes:
There are a range of factors that can cause papilloedema, including: raised intracranial pressure (due to a brain tumor, pseudotumor cerebri, or intracerebral hemorrhage); respiratory failure; hypotony; accutane; and Guillan-Barre syndrome due to elevated protein levels. Approximately half of documented cases occurred in patients with brain tumor.
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