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Simultaneous papilledema and optic disc drusen in a child
Mustafa Komur1, Ayca Sari, Cetin Okuyaz
1Department of Pediatric Neurology, School of Medicine, Mersin University, Mersin, Turkey. drmustafakomur@yahoo.com
Insights
Idiopathic intracranial hypertension (IIH) can present with optic disc drusen. This case report details the youngest patient diagnosed with both conditions, highlighting diagnostic challenges and co-occurrence.
Area of Science:
- Neuro-ophthalmology
- Pediatric Neurology
Background:
- Idiopathic intracranial hypertension (IIH) is a neurological disorder causing elevated intracranial pressure.
- Optic disc drusen are abnormal growths on the optic nerve head, sometimes mimicking IIH symptoms.
Observation:
- A 6.5-year-old boy presented with headache, esotropia, and diplopia, suggestive of IIH.
- Lumbar puncture revealed elevated cerebrospinal fluid pressure, which resolved his symptoms.
- Persistent optic disc elevation post-lumbar puncture led to further investigation.
Findings:
- Ocular ultrasonography confirmed optic disc drusen.
- This patient represents the youngest reported case of coexisting optic disc drusen and IIH.
- The case underscores the importance of differentiating IIH from optic disc drusen in pediatric patients.
Implications:
- Accurate diagnosis is crucial to avoid unnecessary IIH treatment and manage optic disc drusen effectively.
- This case expands the understanding of the co-occurrence of IIH and optic disc drusen in young patients.
- Further research may elucidate shared pathophysiological mechanisms or risk factors.
Abstract:
Idiopathic intracranial hypertension is a headache syndrome characterized by elevated intracranial pressure with normal cerebrospinal fluid content, normal cranial imaging, and elevated appearance of the optic disc. We report on a 6.5-year-old boy with complaints of headache and right esotropia causing diplopia. A lumbar puncture indicated an opening cerebrospinal fluid pressure of 28 cm H(2)O. The headache, diplopia, and esodeviation resolved after the lumbar puncture. However, at 2-week follow-up, the elevated appearance of the optic disc continued despite normal cerebrospinal fluid pressure. A second ophthalmologic consultation revealed optic disc drusen, as also demonstrated by ocular ultrasonography. To date, two such cases have been reported in the literature. To our knowledge, this patient is the youngest with coexisting optic disc drusen and idiopathic intracranial hypertension.
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