Papilloedema
Papilloedema is optic-disc swelling caused by raised intracranial pressure; it is a sign rather than a diagnosis and needs urgent confirmation, brain imaging with venous imaging and specialist management to prevent irreversible visual loss or neurological deterioration.
Definition
Papilloedema is optic-disc swelling caused by raised intracranial pressure. It is usually bilateral but may be asymmetric and is a sign requiring urgent investigation of the underlying cause. Disc swelling from optic neuritis, ischaemic optic neuropathy, infiltration or drusen is not papilloedema.
First principles
Raised pressure is transmitted to the optic nerve head
Cerebrospinal fluid surrounds the optic nerve within its sheath. Raised intracranial pressure is transmitted along that space and disrupts axoplasmic transport where the nerve enters the globe, producing a swollen, elevated disc with blurred margins and venous congestion.
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