swelling of the optic nerve due to increased intracranial pressure
Commonly associated with Idiopathic Intracranial Hypertension (IIH) or other causes of elevated ICP.
Presentation
Symptoms of increased ICP: positional headaches, nausea/vomiting
Visual symptoms: transient visual obscurations, blurry vision, loss of color vision/red desaturation, peripheral vision loss
Evaluation and Management
Consult Ophthalmology and Neurology. Neurosurgery should be involved if there is concern for shunt failure or other neurosurgical problem.
Ophthalmology / Neurology will advise on what imaging to order (usually MRI / MRV brain with and without contrast, + MRI Orbits with and without contrast and fat suppression)
If no contraindications after imaging, obtain LP with opening pressure, with CSF sent for cells, protein, glucose, and infectious/neoplastic workup where appropriate
Ophthalmology / Neurology may recommend PO or IV acetazolamide
