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MedPix® Medical Image DatabaseDisease Topic 1121
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Contributor: James G. Smirniotopoulos, M.D. - Uniformed Services University
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More Like This ? Papilledema
Factoid 1121 - Created: 2001-01-08 19:29:21-05 - Modified: 2002-04-15 22:20:10-04
ACR Codes: 1.3
Edema and swelling of the optic nerve head (optic disc) produced by increased intracranial pressure. Usually bilateral. Central retinal vein compression can occur, however in early stages vision may be near normal. Disc bulging may be due to blocked axoplasmic flow (normally from the retina into the brain). NOTE: Disc bulging NOT due to increased in intracranial pressure should not be called "papilledema".

FINDINGS include:
>Bulging (convex) disc
>Reduced/absent venous pulsation (present in 80% of Nl eyes)
>Small hemorrhages
>Chronic changes include optic atrophy

CAUSES of increased intracranial presure:
>Mass lesion
>>neoplasm
>>hematoma
>>abscess
>Hydrocephalus
>>increased CSF production
>>decreased reabsorption
>>mechanical obstruction of flow
Encephalitis
Pseudotumor cerebri
Massive cerebral infarction

TREATMENT:
Treat the primary cause. If pseudotumor, carbonic anhydrase inhibitors (reduce CSF production, eg. acetazolamide - Diamox) and weight reduction.



http://www.revoptom.com/handbook/sect6b.htm

http://www.eyeweb.org/papilledema.htm

http://www.emedicine.com/OPH/topic187.htm
Location:
Eye and Orbit (exclude Ophthalmology) 		Sublocation:
Optic Nerve and Sheath		Category:
Clinical Vignette or Pearl
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Prepared by: James G. Smirniotopoulos, M.D.
Affiliation: Uniformed Services University - || - Author Profile
Approved by: James G. Smirniotopoulos, M.D.
Affiliation: Uniformed Services University - || - Editor Profile
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