She also complains of frontal headaches for several months. Past medical history is negative. She takes Tetracycline for acne. She is mildly obese with a weight of 83 kg. The pupils are equal and reactive with no afferent pupillary defect.
Motility is full.
The anterior segment is quiet. Dilated examination reveals marked elevation of both optic nerve heads with fine disc hemorrhages bilaterally. There is some obscuration of the disc margins. There is moderate venous dilation bilaterally. There is a small vitreous hemorrhage over the right disc.