Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Apr 1;31(2):436-462.
doi: 10.1212/cont.0000000000001556.

Papilledema

Susan P Mollan
Review

Papilledema

Susan P Mollan. Continuum (Minneap Minn). .

Abstract

Objective: This article describes the recognition, investigation, and management of papilledema.

Latest developments: Papilledema describes optic disc swelling (usually bilateral) arising from raised intracranial pressure. Due to the serious nature of papilledema, there is a fear of underdiagnosis and hence one of the major stumbling points is the correct identification of papilledema. While there has been a stepwise increase in the incidence and prevalence of idiopathic intracranial hypertension due to the worldwide epidemic of people living with obesity, secondary causes such as cerebral venous sinus thrombosis, intracranial masses, and infections must not be missed. Our ability to image the optic nerve has been greatly enhanced by the directed use of optical coherence tomography, with recent studies observing novel imaging findings that can help distinguish pseudopapilledema from papilledema. The structured investigation of papilledema is now routine and research into the management of CSF disorders is finding new avenues for targeted treatments.

Essential points: Confirmation of papilledema typically requires a thorough ocular examination including visual field testing. Ocular imaging such as color fundus photographs and optical coherence tomography are useful. Joint care between ophthalmologists and neurologists is key to treating the underlying condition and managing any visual dysfunction and headache.

PubMed Disclaimer

References

    1. Mollan SP, Spitzer D, Nicholl DJ. Raised intracranial pressure in those presenting with headache. BMJ 2018;363:k3252. doi:10.1136/bmj.k3252 - DOI
    1. Yri HM, Jensen RH. Idiopathic intracranial hypertension: clinical nosography and field-testing of the ICHD diagnostic criteria. a case-control study. Cephalalgia 2015;35(7):553–562. doi:10.1177/0333102414550109 - DOI
    1. Mollan SP, Wakerley BR, Alimajstorovic Z, et al. Intracranial pressure directly predicts headache morbidity in idiopathic intracranial hypertension. J Headache Pain 2021;22(1):118. doi:10.1186/s10194-021-01321-8 - DOI
    1. Wall M, Kupersmith MJ, Kieburtz KD, et al. The idiopathic intracranial hypertension treatment trial: clinical profile at baseline. JAMA Neurol 2014;71(6):693–701. doi:10.1001/jamaneurol.2014.133 - DOI
    1. Buchowicz B, Chen BS, Bidot S, et al. Prediction of postoperative risk of raised intracranial pressure after spontaneous skull base cerebrospinal fluid leak repair. J Neuroophthalmol 2021;41(4):e490–e497. doi:10.1097/WNO.0000000000001118 - DOI

LinkOut - more resources