Papilledema is swelling of a part of your optic nerve called the optic disk, which is found at the point where the nerve enters your eye and joins the retina. Pressure in and around your brain makes the nerve swell. The condition can result from a number of causes and is usually serious.
What Causes Papilledema?
The inside of your skull is a tightly packed area. It’s home to your brain and the fluid that surrounds it, plus a network of blood vessels and nerves. Any change can cause swelling. As pressure rises, your optic nerve can swell.
Papilledema can result from:
- A brain tumor
- A head injury
- Bleeding in your brain
- A blood clot or a problem with certain veins
- Cerebrospinal fluid (CSF) buildup in your brain
- Brain inflammation (encephalitis)
- Inflammation of any of the brain’s coverings, such as meningitis
- Idiopathic intracranial hypertension, meaning pressure builds up in the skull, but doctors can’t figure out what’s causing it
- Pus collecting from a brain infection (abscess)
- Extremely high, uncontrolled blood pressure
You can also get papilledema as a side effect from using -- or stopping -- certain medications, such as:
- Corticosteroids
- Isotretinoin
- Lithium
- Tetracycline
- Nalidixic acid
Papilledema Symptoms
Papilledema doesn’t cause any pain. At first, you may not have any vision problems or other symptoms. Your doctor might notice it during a regular eye exam.
As the disease progresses, you may have short moments of blurred or double vision, flickering, and trouble seeing colors. You may also lose your vision just for just a few seconds. It usually affects both eyes. Other symptoms can include:
- A headache that’s often worse in the morning
- Nausea and vomiting
- Ringing in your ears (tinnitus) or whooshing sounds
How Is Papilledema Diagnosed?
The doctor will do a physical exam to check your overall health and look for any symptoms. They’ll check your vital signs, especially your blood pressure. Often the doctor will look at your eyes with a tool called an ophthalmoscope. This uses a bright light to look into the back of your eye.
You might get other tests to help find out the cause of pressure on your brain. This could include an MRI or CT scan. These tests can look for tumors or other problems.
The doctor may suggest a test called a lumbar puncture, or spinal tap. It measures the pressure of cerebrospinal fluid from the brain. Doctors can check your spinal fluid for signs of an infection or brain tumor.
You could also get an ultrasound of your eye to rule out any other medical conditions.
Papilledema Treatment
Treatment for papilledema depends on the cause.
You might need surgery if a brain tumor is causing the swelling. A brain abscess would be drained and then treated with antibiotics.
You may need to switch to a new medicine if your doctor thinks something you’re taking is causing the swelling.
It’s important to treat papilledema right away. Swelling and pressure in your brain can lead to blindness and other serious problems if left untreated.
