Posterior Globe Flattening without Papilledema in Idiopathic Intracranial Hypertension

A 64-year-old woman had a one-year history of transient visual obscurations in the left eye and was found to have left optic disc oedema with preserved visual function. She was diagnosed with unilateral papilloedema related to idiopathic intracranial hypertension. Magnetic resonance imaging of the orbits showed flattening of the globe in the right eye, which did not have disc oedema. Flattening of the posterior globe without papilloedema suggests that the barrier to transmission of cerebrospinal fluid pressure to optic nerve head is at the level of the lamina cribrosa and may be due to connective tissue changes in this area.