[Emergency] Atlas of Papilledema

These are pictures of Papilledema. This is a part in Fundoscopic findings of the Atlas of Emergency Medicine book


Clinical Summary

Papilledema involves swelling of the optic nerve head, usually in association with elevated intracranial pressure. The optic disks are hyperemic with blurred disk margins; the venules are dilated and tortuous. The optic cup may be obscured by the swollen disk. There may be flame hemorrhages and infarctions (white, indistinct cotton wool spots) in the nerve fiber layer and edema in the surrounding retina. 
Ocular inflammation (eg, papillitis), tumors or trauma, central retinal artery or vein occlusion, optic nerve drusen, and marked hyperopia may present with similar findings.

Management and Disposition

Expeditious ophthalmologic and medical evaluation is warranted.

Pearls

1. The top of a swollen disk and the surrounding unaffected retina will not both be in focus on the same setting on direct ophthalmoscopy 
2. Papilledema is a bilateral process, though it may be slightly asymmetric. A unilateral swollen disk suggests a localized ocular or orbital process.
3. Vision is usually normal acutely, though the patient may complain of transient visual changes. The blind spot is usually enlarged.
4. Diplopia from sixth cranial nerve palsy can be associated with increased intracranial pressure and papilledema. 

Papilledema
FIGURE 3.25 Papilledema. Note blurred disk margins and congested disk.  

Papilledema
FIGURE 3.26 Papilledema. Disk is hyperemic and swollen 
with loss of sharp margins. The venules are dilated and tortuous. The cup is
obscured. A small flame hemorrhage is seen at 12- to 1-o’clock position on the disk margin.

REFERENCES
The Atlas of Emergency Medicine, Fourth Edition, 2016.

COMMENTS

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CLINICAL ATLAS,118,DERMATOLOGY ATLAS,10,EMERGENCY ATLAS,44,HAEMATOLOGY ATLAS,23,HUMAN ANATOMY,1,MICROBIOLOGY ATLAS,66,PARASITOLOGY ATLAS,4,PATHOLOGY ATLAS,22,PEDIATRIC ATLAS,42,STDs,19,SUBCLINICAL ATLAS,116,
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Free Medical Atlas: [Emergency] Atlas of Papilledema
[Emergency] Atlas of Papilledema
These are pictures of Papilledema. This is a part in Fundoscopic findings of the Atlas of Emergency Medicine book
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