Bilateral disc edema. An enlarged blind spot in both eyes, which corresponds to the papilledema. Other visual field defects may also be present, particularly in the inferonasal quadrant. An MRI or CT of the brain, to evaluate potential causes of elevated intracranial pressure, especially tumor. The opening pressure in this patient was 450mm of water, and the CSF composition was normal.
Treatment begins with weight loss and careful observation with serial visual field examinations.
Oral acetazolamide may be used to decrease CSF production and lower intracranial pressure. Optic nerve sheath fenestration of the more severely affected eye. This may also relieve the edema of the contralateral optic disc. All rights reserved. Reproduction in whole or in part in any form or medium without express written permission of the Digital Journal of Ophthalmology is prohibited.