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Papilledema

Bilateral optic disc swelling caused by elevated intracranial pressure.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Göz Hastalıkları department. Book Appointment →

What is Papilledema?

Papilledema is swelling of the optic nerve head due to elevated intracranial pressure (ICP) transmitted through the cerebrospinal fluid in the optic nerve sheath. It is almost always bilateral, although it may be asymmetric.

Causes include intracranial mass lesions (tumors, abscesses), idiopathic intracranial hypertension, cerebral venous sinus thrombosis, hydrocephalus, malignant hypertension and meningitis. Visual symptoms are often initially absent, with transient visual obscurations being typical early signs.

Urgent neuroimaging (MRI with venography) and lumbar puncture (after imaging excludes a mass) are essential. Untreated papilledema can cause severe optic atrophy and irreversible blindness.

Symptoms

Headache (worse with lying down or Valsalva)
Transient visual obscurations lasting seconds
Pulsatile tinnitus
Diplopia (especially with sixth-nerve palsy)
Nausea and vomiting
Bilateral disc swelling with blurred margins
Visual field defects, especially enlarged blind spot

Risk Factors

Obesity in young women (idiopathic intracranial hypertension)
Intracranial tumor
Cerebral venous sinus thrombosis
Use of tetracycline, vitamin A, retinoids
Hypercoagulable states
Chronic kidney disease
Sleep apnea

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Severe persistent headache with vision changes
  • Transient blackouts of vision
  • Pulsatile tinnitus with headache
  • New double vision
  • Headache with nausea and vomiting
  • Any bilateral disc swelling on examination

Treatment Methods

01
Identify and treat underlying cause (urgent surgery for mass, anticoagulation for venous thrombosis)
02
Acetazolamide and weight loss in idiopathic intracranial hypertension
03
Topiramate as adjunct or alternative
04
CSF shunting (lumboperitoneal or ventriculoperitoneal) in resistant cases
05
Optic nerve sheath fenestration for vision preservation
06
Discontinuation of offending medications
07
Frequent neuro-ophthalmology follow-up with OCT and perimetry

Which Department to Visit?

You can visit our Göz Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Göz Hastalıkları Department

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You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.