Acute visual loss in papilloedema: the diagnostic pitfalls

Papilloedema is the descriptive term for optic disc swelling caused by proven elevated intracranial pressure (ICP). Commonly, there is preservation of vision, particularly central vision, visual acuity and colour vision, early in the disease process. However, some patients with raised ICP may present with a combination of disc swelling and visual loss. We report on two patients who presented with visual loss and optic disc swelling. They were initially referred to the neuro-ophthalmology clinic with a provisional diagnosis of optic neuritis given the clinical picture of disc swelling with reduced visual acuity. However they were subsequently found to have papilloedema.