choked disc

pa·pil·le·de·ma

(pap'il-ĕ-dē'mă), Edema of the optic disc, often due to increased intracranial pressure. Synonym(s): choked disc [papilla + edema]

pa·pil·le·de·ma

(pap'il-ĕ-dē'mă) Edema of the optic disc, due to increased intracranial pressure.
Synonym(s): choked disc, papilloedema.

papilloedema

A non-inflammatory oedema of the optic nerve head produced by raised intracranial pressure, and due most commonly to a cerebral tumour. It can also result from cerebral abscesses, meningitis, encephalitis, subarachnoid haemorrhages, head injury, hydrocephalus, etc. The optic disc appears raised above the level of the retina and its margins are blurred, the central vessels on the surface of the disc are displaced forward, the retinal veins are dilated and there is nearly always a loss of induced venous pulsation. The swollen disc displaces the retina and this causes an enlargement of the blind spot on visual field measurement. In the early stages visual acuity is not affected (unlike in papillitis), although if the condition persists there will be some loss. In advanced stages, there may be haemorrhages around the disc, secondary optic atrophy, exudates, as well as headaches and vomiting. The condition is usually bilateral. Note: also spelt papilledema. Syn. choked disc. See optic atrophy; optic neuritis; pseudopapilloedema; Foster Kennedy syndrome.

Table P1 Differential diagnosis between papilloedema and papillitis
	papilloedema	papillitis
signs
disc elevation	raised	slightly raised
disc hyperaemia	present	present
disc margins	blurred	blurred
retinal veins	congested	congested
haemorrhages	near disc	some in late stage
pupil light reflex	normal	impaired
venous pulsation	absent	present
secondary optic atrophy	present in late stage	may appear in late stage
symptoms
visual acuity	normal, except in late stage	reduced
visual field	enlarged blind spot	central scotoma
diplopia	present	absent
colour vision	normal	impaired
pain	absent	present on moving the eyes
headache	present	absent

pa·pil·le·de·ma

(pap'il-ĕ-dē'mă) Edema of the optic disc.
Synonym(s): choked disc, papilloedema. [papilla + edema]