Papilledema

Question 1

What is papilledema

Answer 1

Swelling of the optic disc
*increased intracranial pressure
*painless, passive, typically bilateral

Question 2

What can papilledema lead to?

Answer 2

Early on it may have vision issues
*enlargement of blind spot without losing acuity

Question 3

If you see papilledema during a PE what must you do?

Answer 3

Immediate search for cause

Question 4

What are the signs of papilledema

Answer 4

1. Headache
2. Nausea, vomiting
3. Binocular horizontal diplopia
4. Pulsatile machine-like sound in ear
5. Flame-shaped hemorrhages in nerve fiber layer adjacent to the disc
6. Enlarged blind spot on visual field

Question 5

How to diagnose papilledema

Answer 5

Emergent diagnosis
*MRI with gandolinium contrast preferred CT
*lumbar puncture possible

Question 6

What is the treatment of papilledema

Answer 6

Treat the underlying cause
1. Initially diuretics (decreased IOP)

Question 7

What is the prognosis of papilledema

Answer 7

1. Chronic papilledema can lead to progressive vision loss (peripheral fields) and eventually complete vision loss