II. Signs
- Early and mild Papilledema
- Subtle gray peripapillary halo
- Normal radial Optic Nerve Head disrupted
- Nerve fibers accentuated by grayish opacity
- Concentric folds of the retinochoroid
- Subtle gray peripapillary halo
- Moderate Papilledema
- Borders of optic disc become obscure
- Disc margins are progressively elevated
- Nerve head diameter increases
- Major blood vessels leaving the disc are obscured
- Severe Papilledema
- Optic Nerve Head protrudes
- Peripapillary halo demarcated
- Optic Cup is obliterated
III. Signs: Associated findings
- Loss of spontaneous Retinal vein pulsations
- Pulsations disappear at CSF Pressure > 250 mm water
- Unreliable sign
- Many normal patients lack venous pulsations
- Hyperemia
- Retinal vessel tortuosity
- Retinal Hemorrhages
- Retinal exudates
- Nerve fiber infarctions (cotton wool spots)
- Optic Nerve pallor
IV. Interpretation
- Suggests Increased Intracranial Pressure
V. Causes: Pseudopapilledema
- Optic disc drusen
- Tilted optic disc
VI. Diagnostics
- Stereoscopic indirect Fundoscopy
-
Optic Nerve
Ultrasound
- Drusen are highly reflective
- Papilledema shows a distended Optic Nerve sheath