Papilledema is a swelling of the optic nerve where it enters the eye in response to an increase in intracranial pressure. It almost always occurs in both eyes and may develop over a period of weeks. The following steps will show diagnose papilledema.
Instructions
1. Obtain the presenting symptoms of papilledema caused directly by the elevated intracranial pressure. These primarily include headaches that become worse upon awakening or coughing. The patient also may suffer from nausea and vomiting, which can be followed by loss of consciousness and even death.
2. Observe visual symptoms. Visual acuity is usually unaffected unless the papilledema is advanced, but may include graying-out or transient flickering. Blurred vision and a constriction of the visual field also can occur. The patient also can experience double vision if the sixth cranial nerve becomes involved.
3. Conduct a general physical to eliminate other possibilities. Elevated blood pressure, neurological problems and a fever also can produce the symptoms described in Steps 1 and 2.
4. Perform a dilated fundus examination to find signs of early papilledema. Slit-lamp biomicroscopy and direct opthalmoscopy can show a slight swelling of the nerve fibers, which is considered a key finding if the swelling obscures the fine peripapillary vessels.
5. Look for signs of advanced papilledema. The nerve fiber swelling will eventually obscure the normal margins of the optic disc, causing it to become grossly elevated. The venous congestion will continue to develop and the retina may develop folds called Paton lines. The optic disk can become gray or pale in cases of chronic papilledema.
Tags: intracranial pressure, patient also