Don’t Let Swollen Optic Nerves Make You Nervous
Don't Let Swollen Optic Nerves Make You Nervous
Brad Sutton, OD, FAAO Clinical Professor
IU School of Optometry
Financial disclosures
No financial disclosures
Examination Techniques
Stereoscopic viewing essential
VA and VF: SVP/EVP
Pupil testing and color vision
Brightness comparison and red cap test
Papilledema
Bilateral* optic nerve head swelling secondary to increased ICP
Swollen, blurred margins with splinter hemorrhages and exudates as well as nerve fiber layer edema. Patton's folds may be seen: chorioretinal folds concentric around the disc
Papilledema
May be asymmetric or very rarely unilateral (sequential swelling-one nerve can swell a few weeks or months before the other)
VA varies but typically mild reduction only or no loss at all
May get diplopia secondary to abducens nerve compression
With increased ICP, can get choroidal folds only (before papilledema) at lower pressure levels
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