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Papilledema

  1. Etiology
    1. Intracranial (B/L symmetric)
      1. Hemorrhage – Subarachnoid haemorrhage*                     
      2. Encephalitis, Meningitis
      3. Neoplasm- glioma, meningioma, neurofibroma etc           
      4. Brain abscess
      5. Pseudotumor cerebri (Benign intracranial hypertension)*
    2. Systemic
      1. Malignant HTn*
      2. Blood dyscrasia
      3. Endocrinal – hyperthyroidism, toxaemia of preg.*
      4. Drugs* – Intensive steroid therapy, OCPs, salicylate intoxication
    3. Orbital
      1. Orbital tumor                   
      2. Orbital cellulitis
      3. Orbital hemangioma                
      4. Tumors of optic nerve
  2. C/F:  Ophthalmoscopic Findings
    1. Swelling of optic disc (6–8D) which spills into periphery producing concentric folds in retina (Paton’s line)*
    2. Hyperemia of disc              
    3. Blurring of disc margin        
    4. Tortuous and dilated veins                                
    5. Retinal hemorrhages
  3. Signs/Symptoms:
    1. Transient obscuration of vision (No decrease in Vision)
    2. Normal color vision*        
    3. Normal pupillary reaction*
    4. Visual field – enlargement of blind spot* (Usually normal)
    5. Associated symptom – headache (Worse in the morning), nausea, vomiting, diplopia
  4. D/D:
    1. Optic neuritis               
    2. Hyperemic discs   
    3. Medullated nerve fibers       
    4. Disc drusen
    5. Pseudotumour cerebri      
    6. Skull malformations      
    7. Pseudopapilloedema

Sequelae – Secondary optic atrophy*





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