Papilledema: Stages, Symptoms, Causes, Diagnosis, and Treatment

What Part of the Eye Does Papilledema Affect?

Papilledema affects the part of the eye called the optic disc, also known as the optic nerve head. The optic disc is located at the back of the eye, surrounding the optic nerve where it leaves the eye and goes towards the brain. Papilledema occurs when intracranial pressure, or pressure within the cranium, makes the optic disc swell.

Is Papilledema a Common Eye Condition?

Papilledema, when caused by idiopathic intracranial hypertension, is an eye condition more common in women and those considered overweight. According to Havard Health, one of the health conditions that can cause papilledema is idiopathic intracranial hypertension, which occurs when the body makes too much spinal fluid. This eye condition is more common in women of childbearing age and those considered overweight.

1. Headaches

Headaches are one of the most common papilledema symptoms, caused by increased intracranial pressure. According to the American Academy of Ophthalmology, headaches associated with papilledema may be worse in the mornings or when lying down.

2. Nausea and Vomiting

Nausea and vomiting are common papilledema symptoms, caused by increased pressure in the cranium. Nausea and vomiting associated with papilledema are usually accompanied by headaches.

3. Double Vision

Double vision, also known as diplopia, is a possible symptom of papilledema. Double vision refers to seeing two images of one object. Double vision associated with papilledema is related to a non-localising sixth nerve palsy, according to Rigi, Almarzouqi, Morgan and Lee in the paper, Papilledema: epidemiology, etiology, and clinical management, meaning that there has been damage to the sixth cranial nerve. The sixth cranial nerve helps move a muscle called the lateral rectus muscle, which plays a part in eye movement.

4. Visual Changes

Visual changes refer to a change in how a person’s vision usually looks and can be a symptom of papilledema. Visual changes related to papilledema include blurry vision as well as a smaller field of vision with a blind spot, according to Harvard Health.

5. Transient Visual Obscurations

Transient visual obscurations are a possible symptom of papilledema and refer to a brief period, usually a few seconds, in which vision goes black, grey or white. Transient visual obscurations can be described as a visual blackout, where a person cannot see. According to Jun B in the paper, Diagnostic Considerations in Patients Presenting with Transient Vision Loss, transient visual obscurations related to papilledema may be binocular meaning it occurs in both eyes, or monocular which is just one eye.

1. Head Injury

A head injury may cause raised intracranial pressure, which can lead to swelling of the optic disc. Head injury refers to a range of injuries that affect the head, including the skull, brain and blood vessels, according to John Hopkins Medicine. Head injuries can lead to swelling in the cranium, which can raise pressure and lead to swelling of the optic nerve.

2. A Brain Tumour

A brain tumour can be a cause of papilledema as a brain tumour can raise pressure in the head, which can lead to swelling of the optic disc. According to an article by Havangi Prakash, Basavaraju and Gowda called, Papilledema and Anemia: A Rare Association, a brain tumour is a space-occupying lesion that can raise pressure in the cranium. According to Havard Health, a significant proportion of people who are diagnosed with brain tumours will also have some evidence of papilledema.

3. Inflammation of the Brain

Inflammation of the brain may cause papilledema as inflammation may raise intracranial pressure, leading to swelling of the optic disc. Inflammation of the brain is called encephalitis and is either caused by an infection or the immune system mistakenly attacking the brain cells, according to Health Direct. Meningitis, which is an infection of the meninges or the membrane covering the brain and spinal cord, may also lead to papilledema.

4. High Blood Pressure

High blood pressure may be a cause of papilledema. According to Havard Health, a rise in pressure in the cranium due to high blood pressure can lead to swelling of the optic disc and papilledema. High blood pressure, also known as hypertension, refers to a condition in which the pressure pushing blood around the body through the veins, is too high.

5. Bleeding of the Brain

Bleeding of the brain, also known as a haemorrhage, may cause papilledema as this condition can raise intracranial pressure, leading to a swelling of the optic nerve. Bleeding of the brain may be caused by head trauma, high blood pressure and blood clotting disorders.

6. Idiopathic Intracranial Hypertension

Idiopathic intracranial hypertension may cause papilledema as this condition causes increased pressure in the cranium, which can lead to swelling of the optic nerve. Idiopathic intracranial hypertension refers to an increase of pressure in the cranium and around the brain, due to a build-up of cerebrospinal fluid. Idiopathic intracranial pressure is more common in those of childbearing age with a higher BMI, according to The Brain Tumour Charity. Idiopathic intracranial hypertension can be caused by a range of factors including medication, such as antibiotics or lithium, as well as hormone conditions and iron deficiency anemia.

Is Papilledema Hereditary?

Papilledema is not itself hereditary, but the underlying causes of papilledema may be hereditary. High blood pressure is a possible cause of papilledema due to the pressure it can cause in the cranium. If a person has a family history of papilledema, then they may be at a higher risk of developing it.

Is it Easy to Diagnose Papilledema?

Diagnosing papilledema can be a relatively easy and straightforward process for an optometrist or eye care professional. It may be harder and require more extensive testing to diagnose the underlying cause of papilledema, such as idiopathic intracranial hypertension or a brain tumour.

How Long Does it Take to Diagnose Papilledema?

It may only take the length of an eye test for an optometrist to diagnose papilledema, around 20-30 minutes. If an optometrist requires more extensive testing, such as an MRI, this may take longer.

How Long Does Treatment Last for Papilledema?

The length of time treatment lasts for papilledema depends on what underlying issue is being treated and what treatment method is used. If a person is being treated for idiopathic intracranial hypertension, it may take several weeks for medication to become effective in draining fluid and lowering intracranial pressure.

Can Papilledema be Treated at Home?

In certain cases of papilledema, at-home treatment can occur and primarily include weight loss. According to Kupersmith, Gamell, Turbin, Peck, Spiegel and Wall in the study, Effects of weight loss on the course of idiopathic intracranial hypertension in women, it was found that weight loss was associated with quicker recovery times for those with papilledema.

Do You Need Eye Surgery to Treat Papilledema?

Eye surgery is not typically the main treatment for papilledema, but it can occur. Treatment for papilledema usually involves treating the underlying condition causing the papilledema, such as taking medication for idiopathic intracranial hypertension. According to the NHS, eye surgery may be used to relieve pressure and help fluid drain away. A type of eye surgery called optic nerve sheath fenestration may be used to relieve pressure on the optic disc by opening the protective layer around the optic nerve.

Can Papilledema be Treated Permanently?

Papilledema may be treated or resolved permanently if treatment is swift, the underlying health condition is resolved and vision loss has not occurred.

Can Papilledema be Prevented?

Prevention of papilledema primarily revolves around preventing a rise of intracranial pressure and conditions that cause it, which leads to swelling of the optic disc. To prevent head injuries, for example, it may be advised to wear protective headgear. To prevent high blood pressure, it may help to maintain a healthy weight, quit smoking and eat a balanced diet.