Papilloedema

Papilloedema is a non-inflammatory congestion of the optic disc, invariably associated with raised intracranial pressure. It is most often bilateral. General features reflect the underlying disease process but a choked disc is characteristic although differentiation from papillitis may be difficult.

Vision is rarely affected in acute papilloedema but peripheral vision may be lost in chronic cases where it is frequently accompanied by transient visual obscurations.

Papilloedema will not occur in the presence of optic atrophy as in the Foster-Kennedy syndrome where there is unilateral optic atrophy and contralateral papilloedema, or if the optic nerve sheath on that side is not patent.

Notes:

• Foster-Kennedy Syndrome is characterized by papilloedema in one eye and optic atrophy in the other
  • results from simultaneous raised intracranial pressure and optic nerve compression secondary to tumour - classically, a meningioma of the olfactory groove, or more commonly, due to a meningioma of the sphenoid wing