PAPILLEDEMA


Papilledema is an ocular condition that causes swelling of the optic nerve. It is commonly bilateral, affecting both eyes, affects both sexes equally, can occur at any age, and is most commonly caused by increased pressure in the brain. Each optic nerve transmits visual impulses from the retina and transmits the nerve impulses to the brain. The optic nerve is covered by the same protective sheath or linings that cover the brain and spinal cord. This sheath is regarded as a continuation of the central nervous system and part of its function is to bath the tissue it lines with cerebrospinal fluid (CSF). As a result, brain diseases that cause an increase in CSF pressure can also cause an increase in fluid pressure in the optic nerve. When papilledema is found it can also indicate the presence of intracranial hypertension. Intracranial hypertension is a neurological condition that is caused by increase pressure around the brain. This condition can occur in all age groups but is most often seen in young women, especially those with obesity or on oral contraceptives.

When papilledema is observed from analysis of the central retina, it requires careful medical assessment to prevent or minimize vision loss. It can occur over hours or weeks. This ocular condition can be asymptomatic, however symptoms can include headaches in the early stages, blurring of vision, transient periods of vision loss, inability to see a particular part of vision, double vision, nausea, and vomiting.

Treatment of papilledema is aimed at trying to determine the underlying cause of the brain disease. If increased intracranial pressure is the cause, treatment may include medications or lumbar puncture. Space-occupying lesions in the brain and central nervous system must also be ruled-out. Imaging studies (MRI), neurologic examination, and/or, internal medicine consultations may be needed to definitively identify the underlying cause.

 
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