Or papilloedema is optic disc swelling that is caused by intracranial hypertension. The swelling is usually bilateral and can occur over a period of hours to weeks. Unilateral presentation is extremely rare. Papilledema is mostly seen as a symptom resulting from another pathophysiological process.
In intracranial hypertension, papilledema most commonly occurs bilaterally. When papilledema is found on funduscopy, further evaluation is warranted as 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.
Unilateral papilledema can suggest orbital pathology, such as an optic nerve glioma.
The decision to admit a shunt-treated patient from the emergency department for symptoms related to idiopathic intracranial hypertension (IIH) is challenging. Knowledge of factors associated with the need for admission and/or shunt revision is required. In a study, factors such as male sex, younger age at presentation, lower number of prior emergency department visits, and performance of a diagnostic LP were independent predictors of admission. In addition, papilledema was strongly predictive of the need for shunt revision, highlighting the importance of an ophthalmological examination for shunt-treated adults with IIH who present to the emergency department 1).