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 ?
Papilloedema is swelling (oedema) of the optic nerve head due to raised ICP:
1) Patients present with fever, headache, vomiting, seizures, altered state of consciousness, papilloedema and focal neurological deficits.
a Papilloedema b Choroiditis c Papillitis d Optic disc pit 02 Considering the history and fundus photograph shown in Image A, what are you most likely to see when examining the other eye?
Abnormal neurological examination (focal neurological signs, abnormal eye movements, ataxia, hemiparesis, papilloedema )
I had a patient who needed to be seen urgently by an ophthalmologist because I had found papilloedema and suspected that it was due to raised intra-cranial pressure.
Optic nerve swelling or papilloedema can occur if intracranial pressure is raised following a brain injury (Figure 2).
Having contacted the local hospital eye service (HES) by telephone, suspecting early optic neuritis or papilloedema, an appointment was arranged for the patient to be seen by a consultant ophthalmologist for further investigation.
A build-up of blocked axoplasm in the optic nerve head becomes visible as a swelling, causing the appearance of papilloedema (Figure 1).
When the optic nerves are swollen, eg in papilloedema, there are often flame haemorrhages in the retina surrounding the optic nerve head.
Gradual, bilateral--refractive error, cataract, dry AMD, glaucoma, papilloedema, retinitis pigmentosa, hypertensive retinopathy and diabetic retinopathy
As a result, patients may develop a variety of visual sensory disorders during the course of the disease such as visual field defects, (32) cortical blindness, (33) optic neuritis, papilloedema and optic atrophy.
I had a patient who had papilloedema which in the UK would lead to an emergency hospital referral but in rural Romania there was nothing they could do which was very upsetting.