#39. Papilloedema. Inflammation of the optic nerve - papillitis, retrobulbar neuritis.

Question 1

What is PAPILLOEDEMA?

Answer 1

• SWELLING of the OPTIC NERVE
• DUE to INCREASED INTRACRANIAL Pressure

Question 2

What is the CAUSE of PAPILLOEDEMA?

Answer 2

• RAISED Intracranial Pressure
• SPACE-OCCUPYING Lesion
• HYDROCEPHALUS
• MALIGNANT Hypertension
• DIABETIC Papillopathy
• INFILTRATIVE Papilloedma
• TOXIC CHEMICALS = Ethambutol
• TRAUMA

Question 3

What are the CLINICAL FEATURES of PAPILLOEDEMA?

Answer 3

• Normal or SEVERELY REDUCED Visual Acuity
• Episodes of Unilateral / Bilateral TRANSIENT Visual Loss - lasts for few sec
• REDUCED Colour Vision
• ENLARGED Blind Spot

Question 4

What is INVESTIGATED for PAPILLOEDEMA?

Answer 4

• Blood Pressure
• Glucose
• Differential WBC Count
• Urea, Creatinine
• ESR
• Neuroimaging
• Lumbar Puncture
• Visual Field

Question 5

What is the TREATMENT for PAPILLOEDEMA?

Answer 5

• TREAT Underlying Cause
• BIOPSY to check whether Brain Tumour is Present
• DECREASE Intracranial Pressure = MEDICATIONS (Acetazolamide / Furosemide)

Question 6

What is PAPILLITIS?

Answer 6

• Inflammation of OPTIC DISC in 1 of the eyes.
• Associated with OPTIC NEURITIS
• EARLY WARNING SIGN for MULTIPLE SCLEROSIS

Question 7

What are the CLINICAL FEATURES of PAPILLITIS?

Answer 7

• SIGNIFICANT Vision Loss
• OPACIFICATION of INNER DISC
• CHANGES in way Pupil REACTS to Light
• PAIN when MOVING Eye
• LOSS of COLOUR Vision

Question 8

What are the CAUSES of PAPILLITIS?

Answer 8

• Viral / Bacterial Infection = Sinusitis
• Toxicity to Certain Drugs
• Vitamin B12 DEFICIENCY

Question 9

What is the DIAGNOSIS for PAPILLITIS?

Answer 9

FULL MEDICAL EXAM
- Colour Vision Testing
- MRI of Brain / Optic Nerve
- Visual Acuity Testing
- Ophthalmoscopy = Looking at OPTIC DISC

Question 10

What is the TREATMENT for PAPILLITIS?

Answer 10

• TREAT Underlying Cause
• INTRAVENOUS Steroids = TO SPEED UP Recovery Process

Question 11

What is RETROBULBAR NEURITIS?

Answer 11

• Inflammation of RETROBULBAR Part of the Nerve (BEHIND the GLOVE)
• SPARING of the Nerve Head

Question 12

What are the SYMPTOMS of RETROBULBAR NEURITIS?

Answer 12

• REDUCED Visual Acuity
• RED Desaturation
• Afferent Papillary DEFECT