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How to diagnose papilloedema.

Michael C Lowe1, Gabriele Berman2, Fernando Labella Álvarez3,4

  • 1Department of Neurology, Institute of Neurological Sciences, Glasgow, Scotland, UK.

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|January 13, 2026
PubMed
Summary
This summary is machine-generated.

Papilloedema, optic disc swelling from high intracranial pressure (ICP), requires careful diagnosis. This guide helps differentiate true papilloedema from other conditions to avoid unnecessary treatments and ensure appropriate patient investigation.

Keywords:
BENIGN INTRACRAN HYPCLINICAL NEUROLOGYNEUROOPHTHALMOLOGY

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Area of Science:

  • Ophthalmology
  • Neurology

Background:

  • Papilloedema, characterized by optic disc swelling, is a critical sign of elevated intracranial pressure (ICP).
  • Accurate diagnosis is essential, as overdiagnosis can lead to iatrogenic harm through unnecessary investigations and treatments.
  • Differential diagnosis of swollen optic discs is crucial for appropriate patient management.

Purpose of the Study:

  • To outline a systematic approach for the clinical assessment of suspected papilloedema.
  • To discuss the utility and potential pitfalls of eye clinic tools in diagnosing papilloedema.
  • To propose a strategy for investigating the causes of raised ICP in patients with probable papilloedema.

Main Methods:

  • Clinical assessment incorporating patient history and physical examination.
  • Utilizing eye clinic technologies such as perimetry and optical coherence tomography (OCT).
  • Reviewing diagnostic strategies for identifying causes of elevated ICP.

Main Results:

  • The study emphasizes the importance of a structured approach to differentiate true papilloedema from other optic neuropathies.
  • Identifies potential challenges and pitfalls associated with diagnostic technologies like OCT.
  • Highlights strategies for effective investigation of underlying causes of increased ICP.

Conclusions:

  • A thorough clinical evaluation combined with appropriate technology use is key to accurate papilloedema diagnosis.
  • Awareness of diagnostic pitfalls can prevent misdiagnosis and iatrogenic harm.
  • A clear investigation pathway ensures timely identification and management of elevated ICP.