No racial predilection exists. Most symptoms in a patient with papilledema are secondary to the underlying elevation in intracranial pressure. This eventually may be followed by a loss of consciousness, pupillary dilation, and death. Blurring of vision, constriction of the visual field, and decreased color perception may occur. Diplopia may be seen occasionally if a sixth nerve palsy is associated.
Visual acuity is preserved except in very advanced disease.
In particular, check the blood pressure to exclude malignant hypertension. The patient should be evaluated for neurologic problems and febrile illness. Visual acuity, color vision, and pupillary examination findings should be normal. A relative afferent pupillary defect is usually absent. An abduction deficit secondary to a sixth nerve palsy sometimes may be seen in association with increased intracranial pressure.