Today,s photo (Case 87) 9/8/2014 Papilloedema Papilloedema is optic disc swelling that is caused by increased intracranial pressure the swelling is usually bilateral and can occur over a period of hours to weeks , Further evaluation with CT ,MRI of the brain and /or spine is usually performed , unilateral papilloedema can suggest an orbital pathology , The different stages of papilloedema are : Enorgegment of the retinal veins , Blurring of the disc margins , A redder disc with loss of the physiological cupping of the disc . Take a full history ,specifically ask about any headaches and their characterstics ( the headache and nusea /vomiting worse on waking ,coughing , bending ). N.B Patients with papilloedema should be considered to have an intracranial mass until proved otherwise . (Q) What are the causes of papilloedema ? (A) (1) Raised intracranial pressure . (2) Malignant hypertension (3) Central retinal vein thrombosis . (4) Optic neuritis/papillitis (5) Rarely hypercapnia ,hypoparathyroidism , (Q) What is the difference between papillitis and papilloedema ? (A) In papillitis the condition is usually unilateral with loss of visual acuity ,whereas in papilloedema the condition is usually bilateral and the visual acuity remains normal but there is an enlargement of the blind spot . (Q) What is Foster Kennedy syndrome ? (A) Papilloedema on one side and optic atrophy on the other is called Foster Kennedy syndrome . This may be caused by a tumour of the frontal lobe ,which may cause optic atrophy because of the pressure on the optic nerve ,with increase in size of the tumour ,there is a rise in the intracranial pressure ,and this causes papilloedema on the other side .
Posted on: Sat, 09 Aug 2014 06:11:48 +0000