page_title: Papilledema
section_title: Signs and symptoms
hierarchical_section_title: Papilledema / Signs and symptoms
caption_attribution_description: English: Papilledema revealed by scanning laser ophthalmoscopy (top) and laser Doppler holography (bottom). Healthy eye (left). Pathological eye (right).
context_page_description: Papilledema or papilloedema is optic disc swelling that is caused by increased intracranial pressure due to any cause. The swelling is usually bilateral and can occur over a period of hours to weeks. Unilateral presentation is extremely rare.
  In intracranial hypertension, the optic disc swelling most commonly occurs bilaterally. When papilledema is found on fundoscopy, further evaluation is warranted because vision loss can result if the underlying condition is not treated. Further evaluation with a CT or MRI of the brain and/or spine is usually performed. Recent research has shown that point-of-care ultrasound can be used to measure optic nerve sheath diameter for detection of increased intracranial pressure and shows good diagnostic test accuracy compared to CT. Thus, if there is a question of papilledema on fundoscopic examination or if the optic disc cannot be adequately visualized, ultrasound can be used to rapidly assess for increased intracranial pressure and help direct further evaluation and intervention. Unilateral papilledema can suggest a disease in the eye itself, such as an optic nerve glioma.
context_section_description: In the early stages, papilledema may be asymptomatic or present with a headache. It can progress to enlargement of the blind spot, blurring of vision, visual obscurations (inability to see in a particular part of the visual field for a period of time). Ultimately, total loss of vision can occur.
  The signs of papilledema that are seen using an ophthalmoscope include:
  venous engorgement (usually the first signs)
  loss of venous pulsation
  hemorrhages over and/or adjacent to the optic disc
  blurring of optic margins
  elevation of the optic disc
  Paton's lines (radial retinal lines cascading from the optic disc)
  On visual field examination, the physician may elicit an enlarged blind spot; the visual acuity may remain relatively intact until papilledema is severe or prolonged.
caption: Papilledema (right) revealed by scanning laser ophthalmoscopy (top) and laser Doppler imaging (bottom). Healthy contralateral eye (left).