papilloedem

Papilloedema refers to swelling of the optic disc, which is the point where the optic nerve enters the back of the eye. This swelling is caused by increased intracranial pressure, meaning there is too much pressure inside the skull. This pressure can be due to various reasons, including brain tumors, bleeding in the brain, infections like meningitis, or hydrocephalus, a condition where there is excess cerebrospinal fluid. Idiopathic intracranial hypertension, previously known as pseudotumor cerebri, is another common cause, where the pressure is elevated without a clear underlying cause.

Symptoms of papilloedema can be subtle initially and may include transient visual obscurations, brief episodes of blurred vision that last for a few seconds. Headaches are also a common complaint, often worse in the morning or when lying down. Nausea and vomiting can also occur. In some cases, individuals may experience pulsatile tinnitus, a rhythmic sound in the ears that corresponds to their heartbeat. As the condition progresses, persistent blurred vision, double vision, and eventually visual field defects or loss can develop.

Diagnosis of papilloedema is typically made during an eye examination using an ophthalmoscope. The optic disc will appear swollen, with blurred margins and may show engorged blood vessels. Other diagnostic tests may be performed to identify the underlying cause of the increased intracranial pressure, such as MRI or CT scans of the brain, and lumbar puncture to measure cerebrospinal fluid pressure. Treatment focuses on reducing the intracranial pressure. This may involve addressing the underlying cause, such as surgery for a tumor, or managing idiopathic intracranial hypertension with medications like acetazolamide or by performing serial lumbar punctures. Prompt diagnosis and management are crucial to prevent permanent vision loss.