papilloedema


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Papilloedema with swelling of the optic nerve head, caused by increased intracranial pressure with oedema-induced blurring of the disk margins and obliteration of the optic cup, elevation of the nerve head, capillary congestion, hyperemia, venous engorgement, loss of venous pulse, peripapillary exudates, retinal wrinkling, and punctate nerve fiber layer hemorrhage; if pressure is reduced, fundus returns to normal without loss of vision; increased intracranial pressure is due to meningoencephalitis, hemorrhage, metabolic disease, toxins, trauma, or tumours

pa·pil·le·de·ma

(pap'il-ĕ-dē'mă)
Edema of the optic disc, due to increased intracranial pressure.
Synonym(s): choked disc, papilloedema.

papilloedema

Swelling and protrusion of the OPTIC DISC at the back of the inside of the eye. This is visible by means of an OPHTHALMOSCOPE and is an important indication of a rise in the pressure within the skull. Raised pressure is transmitted along the sheaths of the optic nerves. Papilloedema is always serious and may indicate a brain tumour or other major disorder. Early observation of papilloedema may be life-saving.

papilloedema 

A non-inflammatory oedema of the optic nerve head produced by raised intracranial pressure, and due most commonly to a cerebral tumour. It can also result from cerebral abscesses, meningitis, encephalitis, subarachnoid haemorrhages, head injury, hydrocephalus, etc. The optic disc appears raised above the level of the retina and its margins are blurred, the central vessels on the surface of the disc are displaced forward, the retinal veins are dilated and there is nearly always a loss of induced venous pulsation. The swollen disc displaces the retina and this causes an enlargement of the blind spot on visual field measurement. In the early stages visual acuity is not affected (unlike in papillitis), although if the condition persists there will be some loss. In advanced stages, there may be haemorrhages around the disc, secondary optic atrophy, exudates, as well as headaches and vomiting. The condition is usually bilateral. Note: also spelt papilledema. Syn. choked disc. See optic atrophy; optic neuritis; pseudopapilloedema; Foster Kennedy syndrome.
Table P1 Differential diagnosis between papilloedema and papillitis
papilloedemapapillitis
signs
disc elevationraisedslightly raised
disc hyperaemiapresentpresent
disc marginsblurredblurred
retinal veinscongestedcongested
haemorrhagesnear discsome in late stage
pupil light reflexnormalimpaired
venous pulsationabsentpresent
secondary optic atrophypresent in late stagemay appear in late stage
symptoms
visual acuitynormal, except in late stagereduced
visual fieldenlarged blind spotcentral scotoma
diplopiapresentabsent
colour visionnormalimpaired
painabsentpresent on moving the eyes
headachepresentabsent

pa·pil·le·de·ma

(pap'il-ĕ-dē'mă)
Edema of the optic disc.
Synonym(s): choked disc, papilloedema.
[papilla + edema]
References in periodicals archive ?
Seizures and papilloedema were excluded from these analyses, as numbers were too small for these variables.
This is an initial marker of raised ICP, and may be an early sign of impending papilloedema.
The presence of papilloedema and a head tilt are not uncommon in the presence of severely raised ICP secondary to intracranial tumors.
She was referred to a specialist, had a CAT scan and was diagnosed with papilloedema, where pressure puts enormous strain on the eye.
The patients also had papilloedema on examination but no neurological deficits.
Bilateral papilloedema was seen in two patients, both of whom required ventilation and had bilateral facial nerve palsies, severe quadriparesis, areflexia, extensor planters, and raised CSF protein (1.
Cerebellar signs (28%) and papilloedema (12%) were noted in pilocytic astrocytoma, medulloblastoma and haemangioblastoma.
bulging fontanel, papilloedema and signs of meningeal irritation to exclude meningitis.
Whilst chronic hypertension patients will often have subtle fundoscopic abnormalities, ophthalmological review for evidence of acute changes including new retinal haemorrhages or exudates together with papilloedema should be carried out.
Hypertensive retinopathy was graded 1-4 according to the presence of silver wiring, arteriovenous nipping, haemorrhages/exudates or papilloedema, respectively.
Superior sagittal sinus is most commonly affected and leads to headache papilloedema, and raised intracranial tension.