PAPILLOEDEMA….This means oedema of the optic papilla, optic nerve head or disc. On ophthalmoscopic examination the diagnostic signs are (see Figs. 10.10 and 10.11)
- Increased pink colouration of the optic disc.
- Congested retinal veins.
- Blurring of the disc margin commencing from the nasal side.
- Fullness of the physiological cup.
- Swelling of the optic disc, sometimes formation of “macular fan”
- Haemorrhage in and around the disc.
- Blood vessels cannot be traced upto the centre of the disc…..PAPILLOEDEMA
The visual changes are concentric peripheral scotoma with enlargement of the “blind spot” ultimately leading to blindness.
CAUSES OF POPILLOEDEMA
Intracranial tumour or other space occupying lesions (such as abscess, arachnoiditis) particularly involving cerebellum, temporal lobe and the fourth ventricle.
- Malignant hypertension.
- Chronic nephritis.
- Meningitis (acute) and arachnoiditis.
- Cerebral haemorrhage and subarachnoid haemorrhage, Hypertensive encephalopathy
- Thrombosis of the central vein of retina and cavernous sinus thrombosis, cortical thrombophlebitis, dural sinus thrombosis, anterior ischaemic optic neuropathy
- Optic neuritis and retrobulbar neuritis.
- Pulmonary encephalopathy.
- Severe anemia as in some cases of haematemesis, melaena, leukaemia, etc.
- Guillain-Barre syndrome.
- Intoxication, e.g. lead poisoning and hyper-vitaminosis A, methylalcohol. | PAPILLOEDEMA
- Orbital tumours.
- Grve’s diseasea with exophthalmos.
- Hypocalcaemia etc.
- Idiopathic intracranial hypertension.
- Posterior uveitis and posterior scleritis.
- Optic nerve compression from meningioma of nerve sheath, infiltration from leukaemia, sarcoidosis, lymphoma etc.
- Optic disc drushen (Psudopapilloedema).
The underlying causes should be treated as far as practicable.