When the optic nerve, which connects the eye to the brain, becomes swollen as a result of increasing skull pressure, it is called papilledema. Papilledema can be a sign of a serious underlying condition that requires urgent medical attention. It can affect the flow of blood and fluid drainage in the eye, resulting in vision problems and other symptoms.
Causes
There are a variety of factors that can increase pressure on the brain and optic nerve, including:
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Trauma or injury to the head
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Tumor or abscess of the brain
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Hemorrhage or bleeding in the brain
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An infection or inflammation of the brain, such as meningitis or encephalitis
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The buildup of cerebrospinal fluid (CSF) in the brain is called hydrocephalus
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Young women with obesity are more likely to suffer from idiopathic intracranial hypertension (IIH), which is an unknown cause of intracranial pressure.
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Hypertension or hypertensive crisis
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Low red blood cell count or anemia
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Medications such as corticosteroids, antibiotics, and lithium may cause these side effects
Symptoms
Papilledema is characterized by changes in vision, such as:
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Vision blurred or doubled
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Light flashes or flickers
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Peripheral or side vision loss
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Vision loss due to color
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In the dark, it is difficult to see
Papilledema may also cause the following symptoms:
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A headache, especially in the morning or when posture changes
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Vomiting and nausea
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Tinnitus is a ringing or buzzing in the ears
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Problems with balance or dizziness
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Pain in the neck or shoulders
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Problems with memory or concentration
Diagnosis
In order to diagnose papilledema, a doctor will perform a physical examination and ask about symptoms and medical history. An ophthalmoscope will be used to check for signs of optic nerve swelling, such as:
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Blurred or elevated optic discs
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Blood vessels that are dilated or tortuous
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Bleeding spots or hemorrhages
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Damaged nerve fibers or cotton wool spots
Also, the doctor may order some tests to measure the pressure inside the eye (tonometry) and in the brain (lumbar puncture or spinal tap). To determine the cause of papilledema, the doctor may order a magnetic resonance imaging (MRI) or computed tomography (CT) scan.
Treatment
Treatment of papilledema depends on the underlying cause and the severity of the symptoms. The main goal of treatment is to lower the pressure on the brain and optic nerve, and to prevent or reverse any vision loss.
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CSF production or drainage can be reduced or increased by medications such as diuretics, acetazolamide, or corticosteroids
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People with IIH and obesity should lose weight and eat a low sodium diet
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Diverting excess CSF from the brain to another part of the body through surgery, such as shunting
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Fenestration of the optic nerve sheath, which involves making small cuts to relieve pressure on the nerve
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Treatment of the underlying condition, such as antibiotics for infection, antihypertensives for high blood pressure, or chemotherapy or radiation for cancer
Prevention
The following steps may help reduce the risk or severity of papilledema, but it is not always preventable:
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Keeping your head safe from injury or trauma
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Keeping a healthy weight and blood pressure
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Managing chronic conditions such as diabetes and kidney disease
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Reporting any side effects of medications according to the doctor's instructions
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If you experience any symptoms of papilledema or increased intracranial pressure, seek medical attention as soon as possible
It is important to recognize the signs and symptoms of papilledema and seek medical attention as soon as possible. Papilledema can affect the vision and quality of life of the affected person. Papilledema can be managed with proper diagnosis and treatment, reducing complications.
