PAPILLEDEMA

WHAT IS A PAPILLEDEMA?

Papilla is the name given to the entrance of the optic nerve into the eye. We can see it like a yellowish round disc with well-defined borders in the middle of which the main vessels that nourish the eye emerge (figure 1). This is the only part of the whole optic tract that an ophthalmologist can explore.

Fig. 1: Normal papilla.

When the optic nerve suffers a compression, the papilla usually swells or edematises leading to a typical image in the fundus of ill-defined borders, haemorrhages and vascular tortuosity (figure 2).
By definition, a papilledema is a disorder in both papillae, so this is a bilateral disease.

Papiledema

Fig. 2: Papilledema.

WHAT IS THE CAUSE OF PAPILLEDEMA?

The most frequent cause of papilledema is an increase of the intracranial pressure. There exist several aetiologies that can cause an intracranial pressure rising but the most usual are intracranial haemorrhages, intracranial tumours or benign idiopathic intracranial hypertension also known as pseudotumour cerebri.

WHAT MUST BE DONE IN FRONT OF A PAPILLEDEMA?

Having a papilledema is an ophthalmologic emergency and patients must undergo a radiologic examination of their head and orbit as quickly as possible.
According to the results, the treatment will have to be directed at attending to the underlying cause.
Not solving its cause leads to a progressive optic nerve atrophy and consequently, to a loss of vision.