Papilledema

Papilledema is a medical condition in which the optic nerve at the back of the eye become swollen. Papilledema can be life-threatening so it is very important that the patient receives immediate medical intervention. Papilledema occurs when there is a build-up of intracranial pressure (pressure within the brain) and cerebrospinal fluid is placed on the optic nerve, it can occur in one or both eyes. Papilledema can be caused by a number of serious medical conditions such as a brain tumour, severely high BP (also known as hypertensive crisis), bleeding within the brain or trauma to the brain. 

Symptoms of Papilledema include headaches, visual disturbances (diplopia), nausea, vomiting, a ringing sound in the ears (often pulse-like), although some patients may be asymptomatic. True papilledema is a medical emergency. Not all optic nerve swelling is Papilledema, careful history and examination are needed to differentiate between Papilledema and a number of other causes of optic disc swelling including optic neuritis and central retinal artery or vein occlusion. Unilateral optic disc swelling is more likely to be a result of optic neuritis or retinal artery/vein occlusion. Bilateral swelling is more likely to be a result of Papilledema. If Papilledema is not treated, it can lead to complete vision loss.

Patients presenting with Papilledema may appear asymptomatic in the early stages. The most common of Papilledema are headaches which are usually worse in the morning, nausea and vomiting which are associated with Papilledema, typically as a result sudden onset of pressure. When Papilledema worsens, individuals may experience temporary loss of vision. Each of these symptoms symptoms can result in rapid decline in a patient's central vision.

In addition to an bilateral and hyperemic optic disc, a patient presenting with Papilledema typically have engorged, tortuous retinal veins and retinal hemorrhages around the optic disc but not into the retinal periphery. The time frame for for development of Papilledema can be weeks or even hours. Bilateral papilledema is a medical emergency and requires immediate investigation by an Ophthalmologist.