What is Papilledema and How is it Treated?

Author: Premier Eye Associates

Papilledema is an eye condition in which the optic nerve becomes swollen, or edematous. This swelling is due to an increase in the pressure in the skull.


Basics of the Optic Nerve

The optic nerve is responsible for sending information from the eyes to the brain. The optic nerve connects with the retina in the back of the eye to collect information about vision.

When performing an eye exam, your eye doctor is able to see part of the optic nerve, called the optic nerve head.

The optic nerve head is diagnostic of problems with the entire optic nerve or visual system.

Early detection of glaucoma, optic neuritis, thyroid eye disease, and myasthenia gravis can be made by assessing the optic nerve head.

However, papilledema is assessed and diagnosed by observing the optic nerve head.


What Papilledema Looks Like

Papilledema will have several diagnostic findings when viewing the optic nerve head.

A doctor looking at the optic nerve head would notice that the optic nerve appears raised or elevated.

Typically, the optic nerve head is flat and flush with the surrounding retina. In papilledema, the optic nerve will be raised away from the surrounding retina.

Other signs of papilledema will include the borders of the optic nerve appearing blurry or covering the retinal blood vessels.


What are Symptoms of Papilledema

Papilledema may not cause any symptoms until it is much more advanced in its course, but it may also have a few early symptoms.

The most common symptom experienced is frequent headaches. Typically, these headaches will be pressure in or on the head or feel like a dull ache around the skull.

Another common symptom is slightly blurred vision. Since the optic nerve is responsible for sending information about vision to the brain, if it is damaged or swollen the vision may be impacted.

The blurry vision may not be constant and may get worse with certain triggers or events.


Cause of Papilledema

To have true papilledema, the cause of the optic nerve swelling has to be an increase in the pressure in the skull and spinal cord.

There is a fluid in the skull surrounding the brain called cerebrospinal fluid. In cases of papilledema, there is too much cerebrospinal fluid in the skull and spinal cord.

This can be from an overproduction of cerebrospinal fluid or due to an issue with draining the cerebrospinal fluid.


Diagnosing Papilledema 

To diagnose papilledema, an eye doctor will first examine the optic nerves of both eyes to determine if there is swelling of the optic nerve head.

Once the optic nerve head has been assessed, the next steps include having an MRI of the brain and, if the MRI comes back normal, having a lumbar puncture to determine the pressure in the skull and spinal cord.


Treatment Options 

To treat papilledema, a neurologist and your eye doctor will work together to develop an appropriate plan for your treatment.

Treatment options include oral medications, a shunt to help drain the cerebrospinal fluid, or monitoring for any changes in vision.

If you have papilledema, your doctor will coordinate care and develop the best and most appropriate treatment plan,


Dr. Anthony Spina and the staff of Premier Eye Associates specialize in glasses, soft contact lenses, hard contact lenses, and medical eye exams. Call our eye doctor in Auburn, AL today at (334) 539-5391 or schedule an appointment online  if you are interested in learning more about papilledema.  Our optometrist provides only the highest quality eye care services amongst eye doctors in the Auburn Alabama area.


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