In the old days the optic disc was called the papilla. Papilloedema with swelling of the optic nerve head, caused by increased intracranial pressure with oedemainduced blurring of the disk margins and obliteration of the optic cup, elevation of the nerve head, capillary congestion, hyperemia, venous engorgement, loss of venous pulse, peripapillary exudates, retinal wrinkling, and punctate nerve. In particular, check the blood pressure to exclude malignant hypertension. Doctors and medical researchers define papilledema as a medical condition that affects the eyes of a person.
Find, read and cite all the research you need on researchgate. Papilledema is swelling of your optic nerve, which connects the eye and brain. Papilloedema and optic atrophy free download as powerpoint presentation. Keratoconus is an eye disorder involving a gradual change in the shape of the cornea the clear layer in front of the iris and pupil. It is a silent killer it causes painless complications. Treatment of papilledema is directed at the underlying disorder causing iicp. Papilledema definition papilledema is a swelling of the optic nerve, at the point where this nerve joins the eye, that is caused by an increase in fluid pressure within the skull intracranial pressure. Often an ophthalmologist a medical doctor who specializes in the evaluation and treatment of eye disorders needs to confirm the diagnosis and help determine the cause. Optic disc swelling including papilloedema patient. Papilledema is an optic disc swelling that is secondary to elevated intracranial pressure. The finding of papilledema in a patient without known intracranial disease, should lead to prompt neuroimaging and lumbar puncture.
Surgical intervention is employed when patients present with vision. Papilledema and idiopathic intracranial hypertension. Pituitary tumour, trauma homonymous hemianopia loss of one side of perception lesion is postchiasm and could be anywhere, until the lat. Diagnosis and grading of papilledema in patients with. The history should be taken, and a physical examination, including vital signs, should be performed. Cpd1 you can discuss this case study in practice as part of your cet. Field of vision color of vision neurological investigation visual evoked potential vep blood test papillitis eye disorder inflammation of the optic disc papilla. Papilledema generally resolves 68 weeks after icp is normalized. Papilloedema and optic atrophy retina ophthalmology. The optic nerve carries images from your eye to your brain. Adult patients who present with papilloedema and symptoms of raised intracranial pressure need urgent multidisciplinary assessment including neuroimaging, to exclude lifethreatening causes. This material will help you understand papilledema. To diagnose papilledema, a doctor uses an ophthalmoscope a light with magnifying lenses that is used to look into the back of the eye.
Papilloedema is a medical emergency and no patient should be discharged from hospital without exclusion of a mass lesion sol or venous thrombosis, ie a ct head scan is not sufficient a ct venogram or mr venogram will need to be performed in addition to the ct or mri. Intracranial hypertension and papilloedema in chronic inflammatory demyelinating polyneuropathy. Papilledema is the medical term denoting swelling of optic disc. Papilledema is an ophthalmoscopic diagnosis and refers to swelling of the optic disc. The elevated pressure in the head pushes on the optic nerve. Papilledema definition of papilledema by medical dictionary. Papilledema is used to denote a swelling of the optic nerve head disc resulting from raised intracranial pressure. Where there is no apparent underlying cause for the raised intracranial pressure, patients are considered to have idiopathic intracranial hypertension iih. Any edema of optic nerve head arising from causes other than increased intracranial pressure is termed optic disc edema, and not papilledema.
With grade ii papilledema, the halo becomes circumferential. If papilledema is suspected clinically, magnetic resonance imaging mri with gadolinium contrast or computed tomography ct. They have all been written by the college based on real life situations encountered in. Optic nerve swelling from etiologies other than iicp is characterized as optic disc edema. Papilledema is defined as optic disc edema caused by elevated intracranial pressure icp and should be distinguished from papillitis. Grade i papilledema is characterized by a cshaped halo with a temporal gap. Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. These studies give us pause in relying upon humans including experts to accurately and reliably diagnose and grade papilledema.
Pdf papilledema is optic disc swelling due to high intracranial pressure. There is a lack of inflammation, infiltration or infection of the optic nerve itself. Papilloedema is defined as swelling of the optic nerve head. Careful history and examination are needed to distinguish papilloedema from other causes of optic disc swelling such as central retinal artery or vein occlusion, congenital abnormalities and optic neuritis. Papilloedema the full series of these articles will be available in the book posterior eye disease and glaucoma az by bruce as, oday j, mckay d and swann p. It can develop due to intracranial pressure, infections, or inflammation developed on the optical disc. Responsible for the majority of frequent doctors visits. Papilledema is a condition in which increased pressure in or around the brain causes the part of the optic nerve inside the eye to swell. Aqueous fluid is produced by the ciliary epithelium and travels from the posterior chamber to the anterior chamber through the pupil see figure 3. Papilledema is sometimes found at routine examination in an asymptomatic individual. Papilledema can happen over a time frame of hours to weeks.
Grade iii papilledema is characterized by loss of major vessels as they leave the disc arrow grade iv papilledema is characterized by loss of major vessels on the disc. Pdf on apr 1, 1978, d mcleod and others published papilloedema. Differentiating papilledema from other causes of a swollen optic disk, such as optic neuritis, ischemic optic neuropathy, hypotony, central retinal vein occlusion, uveitis, or pseudo swollen disks eg, optic nerve drusen, requires a thorough ophthalmologic evaluation. Optic disc edema secondary to increased intracranial pressure. Papilledema is optic disc swelling due to high intracranial pressure. Papilledema eye disorders merck manuals professional. In patients with keratoconus, the cornea becomes irregular and coneshaped, and progressively worsens vision. Definition passive hydrostatic non inflammatory swelling of optic nerve head secondary to raised intracranial pressure. Copy of 9 papilloedema new cerebrospinal fluid human eye. Elevated intracranial pressure and pseudotumor cerebri. Possible conditions causing high intracranial pressure and papilledema include intracerebral mass lesions, cerebral hemorrhage.
The elevated pressure in the head pushes on the optic nerve and makes your optic nerve swell. Find powerpoint presentations and slides using the power of, find free presentations research about papilledema ppt. Papilledema specifically refers to optic nerve head swelling secondary to increased intracranial pressure iicp. While papilledema is disc edema secondary to increased intracranial pressure, optic disc drusen also known as pseudopapilledema and optic nerve head drusen represent apparent optic disc swelling that simulates some features of papilledema but is secondary to an underlying, usually benign, process most patients with pseudopapilledema lack visual symptoms, not unlike patients with true. This is a condition that can be found in all age groups but it is fairly uncommon to find it in infants because the bones of their skulls are not fully fused together yet. You may have symptoms like headache or changes in vision.
Papilloedema definition of papilloedema by medical. Full text full text is available as a scanned copy of the original print version. Papilledema definition of papilledema by the free dictionary. The mri appearance relates to the dural anatomy of the optic nerve, which is continuous with the subarachnoid space, thereby allowing increased intracranial pressure icp to be transmitted to the optic disc. Papilloedema it is swelling of optic nerve head due to raised icp. Links to pubmed are also available for selected references. Efforts to refine and provide even more specific criteria for each frisen. Papilledema or papilloedema is optic disc swelling that is caused by increased intracranial pressure due to any cause. Symptoms may be fleeting disturbances in vision, headache, vomiting, or a combination. It usually happens bilateral which means it happens in both eyes. Papilledema is nearly always bilateral, is accompanied by loss of venous pulsations, and varies in appearance from mild to severe fig. Optic disc swelling is distinct from optic disc atrophy which refers to a loss of nerve fibres. The swelling is usually bilateral and can occur over a period of hours to weeks. Optic disc swelling in the absence of raised intracranial pressure is referred to as optic disc edema.
Papilledema medical definition merriamwebster medical. Save page share use the case studies in this section for your own peer discussions. Aqueous fluid is produced by the ciliary epithelium and travels from ppt presentation summary. Grading and differential diagnosis of papilledema by dr. Glaucoma, papilloedema and syphilis bitemporal hemianopia loss of fields which cross over in the chiasm. A practical approach to, diagnosis, assessment and.
Papilledema is the swelling of the optic disc caused by increased intracranial pressure. Pseudopapilloedema optic disc drusen, hyperopia and. Triad of seizure, encephalopathy, and headache is classic acute presentation. Possible conditions causing high intracranial pressure and papilledema. For further information click on the bookstore at adrian bruce is a chief optometrist at the victorian. All patients admitted to a medical ward in this hospital must have a full neurological examination as part of their medical assessment and that this is documented. Swelling of the optic nerve due to other causes such as infection or inflammatory disease is not called papilledema.
Any process which leads to iicp can likewise cause papilledema. This swelling is a reaction to a buildup of pressure in or around your brain that may have many causes often, its. Optic disc swelling in the absence of raised intracranial pressure is referred to as. View and download powerpoint presentations on papilledema ppt. Aetiology demyelinating disease ms metabolic disease as diabetes mellitus infection from other disease as. Thus, detection of papilledema and assessment of visual function are essential to patient management. The causes are protean, a veritable augean stable of conditions see below, the most common of which. Get a printable copy pdf file of the complete article 591k, or click on a page image below to browse page by page. Oculomotor 3rd cranial nerve supplies extra ocular as well as intraocular muscle functional component. To compare the spectral domain optical coherence tomography sdoct findings of the optic disc and the peripapillary retina of patients with a true papilledema and pseudopapilledema with and without optic nerve head drusen onhd. Papilledema eye disorders msd manual consumer version.
The swelling in the optic disc causes problems on the vision and may cause permanent vision loss when not managed. Papilledema is defined as optic disc edema caused by elevated intracranial. Idiopathic intracranial hypertension without papilledema. The disc margins are blurred, with grayish white, opalescent thickening of the peripapillary nerve fiber layer arrows, cottonwool spots, and flame hemorrhages. Papilledema definition, pictures, causes, symptoms. The condition is characterized by a swelling or inflammation of the optic nerves at the rear part of the eye. Understanding papilledema understanding papilledema.
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