Papillary edema is an ocular condition that occurs when pressure in the brain causes the optic nerve to swell.
This condition can have several causes. A mild case of papilledema with symptoms that do not interrupt your life is nothing to worry about. But papilledema can be a sign of an underlying condition or injury that should be treated as soon as possible.
This is especially true if you notice the symptoms after a significant trauma to the head.
The first most common symptoms of papilledema are brief changes in your vision. These changes are barely noticed at the beginning, with blurry images, double vision, flashes, or loss of vision that lasts a few seconds.
If the brain pressure continues, these changes may last minutes or more. In some cases, they can become permanent.
The inflammation of the brain that causes papilledema triggers other symptoms that distinguish it from other eye conditions, including:
- Abnormal headaches
- Ringing in the ears (tinnitus).
Causes of Papillary Edema
The fluid that contains the brain and spinal cord is known as cerebrospinal fluid or CSF. The swelling of the optic nerve can occur when the CSF accumulates where the optic nerve and the central vein of the retina travel between the brain and the ocular nerve.
This area is known as the subarachnoid space. When the pressure pushes the nerve and the vein, blood and fluid can not leave the eye at an average pace, which causes papilledema.
Brain inflammation can be caused by several injuries and conditions, including:
- Traumatic injury to your head.
- Not having enough red blood cells or hemoglobin (anemia).
- Accumulation of CSF in your brain (hydrocephalus).
- Brain bleeding (hemorrhage).
- Brain inflammation (encephalitis).
- Inflammation of brain tissue (meningitis).
- High blood pressure (hypertension).
- Collection of infected pus in the brain (abscess).
- Tumor cerebral.
Sometimes, brain pressure increases for no apparent reason. This is known as idiopathic intracranial hypertension, which is more likely to occur if you are obese.
Your doctor may perform a lumbar puncture, also called a spinal tap, to drain extra fluid from your brain and reduce swelling. Your doctor may also prescribe acetazolamide to keep the nervous system’s pressure at an average level.
If being overweight or obese causes papilledema, your doctor may recommend a weight loss plan and a diuretic, which can help reduce the pressure inside your head.
Your doctor may prescribe medications to reduce swelling. Corticosteroids, such as prednisone, dexamethasone, and hydrocortisone, can be used to keep the swelling in the brain.
These medications can be injected or taken by mouth.
If high blood pressure is causing papilledema, your doctor may prescribe medications to keep your blood pressure under control. Common medications for high blood pressure include:
- Diuretics : bumetanide and chlorothiazide.
- Beta blockers : atenolol and esmilol.
- ACE inhibitors : captopril and moexipril.
If you have a brain tumor, your doctor may recommend surgery to remove part or all of the tumor, especially if the tumor is cancerous. Radiation or chemotherapy can also help the tumor get smaller and reduce swelling.
If an infection is causing your papilledema, your doctor may prescribe antibiotics. The medications for the infection differ depending on the type of bacteria that is causing the infection.
If you have an abscess, your doctor may use a combination of antibiotics and drainage to treat a possible infection, as well as to remove pus or infected fluid from your brain.
If you have just had a major head injury, your doctor will try to reduce the pressure and swelling in your head. This may involve draining the cerebrospinal fluid from the head and removing a small piece of your skull to relieve pressure.
Diagnosis of Papillary Edema
Your doctor will first perform a complete physical examination to monitor your general health and detect other symptoms.
Your doctor is likely to examine your field of vision by moving your hands back and forth beyond your eyes to see where your blind spots are.
Your doctor may also use a tool called an ophthalmoscope to look into each of your eyes for your optic nerve through your pupil, the opening in the front of your eye.
Your doctor can diagnose a case of papilledema if your optic disc, which is at the end of the optic nerve, is abnormally blurred or too high. Your doctor may also see blood spots in your eye if you have this condition.
If your doctor thinks a brain condition is causing papilledema, they will do additional tests. Your doctor may order an MRI test or a CT scan of your head to check for tumors or other abnormalities in your brain and skull.
Your doctor may take a tissue sample (biopsy) from the tumor to look for cancer cells or drain part of the cerebrospinal fluid to look for abnormalities.
A Pap smear can cause blindness if the pressure continues for a long time without treatment, even if there is no underlying condition.
Other complications of untreated papilledema related to the conditions that can cause it include:
- Brain damage.
- Constant headaches.
A Pap smear is not usually a problem in itself. In general, it can be treated by draining extra CSF fluid, which reduces swelling. The symptoms disappear in a few weeks.
The swelling or injury to the brain can be serious and life-threatening. If papilledema is caused by an underlying condition, get treatment right away to prevent long-term complications.
Many of the causes of papilledema can not be prevented. Steps to help prevent some reasons of papilledema include:
- Follow your doctor’s instructions to control high blood pressure and never skip doses of blood pressure medications unless your doctor instructs you to do so.
- Stay in good physical shape and avoid obesity by exercising daily and maintaining a healthy balanced diet.