Papilloedema

Question 1

What causes papilledema?

Answer 1

Raised ICP -> transmitted to the sub-arachnoid space which surround CN II -> swelling of optic disc

Question 2

How does it present on fundoscopy?

Answer 2

Swollen optic disc

• loss of contour
• loss of optic cup
• red/purpely colour

Question 3

How will paitent present?

Answer 3

Vision loss lasts a few seconds but getting progressively longer as ICP increases

• flashing lights
• floaters sometimes
• visual defects really

Question 4

How is it managed?

Answer 4

Medical emergency refer up immediately - need MRI of brain to establish cause

Question 5

How can papilledema be distinguished from other causes of swollen disc?

Answer 5

Papilledema causes bilateral swelling

Question 6

Inside the brain there is a careful balance between brain, blood and CSF. With these three as headings, what can cause raised ICP -> papilledema

Answer 6

Brain
- space occupying lesion

Blood
- malignant HTN

CSF
- idiopathic intracranial HTN

Question 7

What is a very important clinical examination to do?

Answer 7

BP - could be caused by HTN