PapilledemaIntroduction:
This is an acute swelling of the optic nerve head in the back of the eye.
It is almost always on both eyes at the same time. It is an acute emergency that
should be treated right away by an eye specialist. Here are some common causes
of papilledema. Signs and symptoms: There
are no symptoms initially. There may be associated other symptoms from the underlying
diseases such as headaches with many brain tumors or other space occupying brain
lesions. Diagnostic test: When careful visual testing
is done, an increased blindspot would be noticed (visual field testing). Fundoscopic
examination (examination with an ophthalmoscope or a slit lamp) shows
this image. Here is another image that shows how the optic
disc is elevated.
| Causes of papilledema
| | brain tumor or abscess |
| meningitis |
| head trauma (concussion or bleeding) |
| encephalitis | | severe
high blood pressure | | other
diseases, which cause elevated intracranial pressure |
Treatment: Blood pressure needs to be taken
and treated aggressively, if this is the cause for the papilledema. With
head trauma or other causes of increased intracranial pressure this needs to be
reversed by removal of a brain tumor, by a shunt procedure, by diuretic therapy
or other measures. Here is a reference that has more
information on the subject. The treatment is directed at the
identified causal condition. If high blood pressure is the cause, this is aggressively
treated, possibly in an Intensive Care Unit setting for a few days until the danger
of loss of eyesight is over. If meningitis is the cause, this needs to be treated
aggressively.
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