Papilledema is the medical term denoting swelling of optic disc. It can develop due to intracranial pressure, infections, or inflammation developed on the optical disc. One should not confuse papilledema with disc atrophy (that occurs due to loss of nerve fiber on the optical nerve). This condition can produce symptoms like headache, nausea and vomiting also apart from affecting the normal vision. Papilledema can cause blurred vision or flickering vision.
Symptoms :
The prominent symptom of papilledema is optical swelling due to intracranial pressure. In addition, it can cause headache (more when the person wakes up in the morning), nausea and vomiting and rarely loss of consciousness. Some people would have blurred vision, flickering vision and decreased perception of color due to this problem. In some cases diplopia is seen if the sixth nerve palsy is affected.
The symptoms are not found in all the cases. For many people papilledema is found only on routine eye examination. Some of the early signs of papilledema are disc hyperemia, swelling of nerve fiber layer, and small hemorrhages in the nerve fiber layer. Spontaneous pulsation will be missing in many individuals if the intracranial pressure is above 200mm of water. As the disease continues to progress, it can cause swelling of nerve fiber layer with venous congestion.
Causes :
Papilledema develops due to intracranial pressure on the optical disc. Presence of any tumor or lesions on the CNS and cerebral edema can cause this problem. Infectious diseases like meningitis, venous sinus thrombosis and hemorrhage in subarachnoid membrane can cause papilledema. Intake of strong medications like tetracycline, lithium, and corticosteroids can also cause this problem.
Diagnosis :
Neuroimaging tests are highly effective in detecting papilledema. The degree of swelling of optical disc will be assessed using several ophthalmologic tests. Optical coherence tomography will be done to keep track of the changes in the optical disc. If papilledema occurs due to other causes like ischemic optical neuropathy or optic neuritis or retinal vein occlusion then complete ophthalmologic evaluation is to be done. MRI scan will be done to rule out any other clinical causes like venous sinus thrombosis or lesions on the central nervous system.