Optic Nerve Head Elevation Diagnostic Dilemma

Is it or is it not swollen?

• Congenital vs. acquired?
• True vs. pseudo-edema. If true edema, is it with or without optic nerve dysfunction?
• Unilateral vs. bilateral? (unilateral includes neuropathies such as optic neuritis, neuroretinits, papillitis, papilophlebitis, edema due to hypotony)
• AION: arteritic vs. non-arteritic; typically presents as a unilateral finding although can affect the opposite eye within days

Now what to do about it! (This course will concentrate ONLY on the bilateral cases of disc elevation.)

Etiologies of BILATERAL disc swelling/elevation include:

Papilledema Pseudotumor cerebri Malignant hypertension

Thyroid optic neuropathy Diabetic ischemic optic neuropathy (variable laterality) Toxic optic neuropathy Leber hereditary optic neuropathy
Pseudopapilledema (congenital disc anomalies) Congenitally full disc Optic nerve head drusen (ONHD) Malinserted disc Tilted disc syndrome Optic nerve hypoplasia Bergmeister's papilla

	URL: http://www.opt.indiana.edu/ce/ondx/onhddx.htm Revised: July 9, 2007
	IU Optometry home page: http://www.opt.indiana.edu/ Comments (content): Dr. Tiffenie Harris at tlarkins@indiana.edu Comments: Web Administrator Page design and coding: Terri Greene Copyright © 2007, The Trustees of Indiana University