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papilloedemaSwelling 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.
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|
|disc elevation||raised||slightly raised|
|haemorrhages||near disc||some in late stage|
|pupil light reflex||normal||impaired|
|secondary optic atrophy||present in late stage||may appear in late stage|
|visual acuity||normal, except in late stage||reduced|
|visual field||enlarged blind spot||central scotoma|
|pain||absent||present on moving the eyes|
[papilla + edema]