Papillodema

Definition of true paillodema: Swollen optic nerve head due to raised ICP caused by blockage to axoplasmic flow.

Causes of optic disc swelling:

1. Raised ICP (haematoma, hydrocephalus, tumors, brain swelling)
2. Failure of normal axoplasmic flow: mechanical compression, ischemia
3. Odema: retinal vein occulusion, inflammation
4. Cellular infiltrates: inflammation, neoplasia.

Clinical features:

1. Optic nerve dysfunction- early transient visual blurring. VA loss is late. field defects are variable. Can be a enlarged blind spot but commonly affects central vision. Colour vision(red-green defect) loss occur. RAPD may be present.
2. Underlying disease
3. Associated features (esp of raised ICP)

Investigations:

1. Fundoscopy: blurred optic disc and cup margins.
2. MRI: to investigate cause.

If untreated, optic atrophy(pale optic disc) results.