HomeHealth articlesbilateral papilledemaWhat Is Papilledema?

Papilledema - Causes, Symptoms, Diagnosis, and Treatment

Verified dataVerified data

4 min read


Papilledema is the optic disc swelling that occurs due to an increase in intracranial pressure. Read this article to know more.

Medically reviewed by

Dr. Shikha Gupta

Published At January 5, 2023
Reviewed AtFebruary 22, 2023

What Is Papilledema of the Eye?

Papilledema is a serious condition of the eye. In this condition, the swelling of the optic disc takes place. This is caused due to increase in intracranial pressure. It may develop suddenly, or it may develop over a period of time. A medical professional should be consulted at the earliest as it may denote any serious underlying medical condition, such as a brain tumor, any inflammation of the central nervous system, and an increase in intracranial pressure due to unknown causes.

Papilledema cannot exist without an increase in intracranial pressure. Hence, it is always secondary to the rise in intracranial pressure. It can occur in both eyes simultaneously.

What Are the Symptoms of Papilledema?

Papilledema occurs following the increase in intracranial pressure. It may occur for a few seconds or may even be present throughout. The following may be the symptoms of papilledema:

Initial symptoms:

  1. Blurring of Vision: The pupils may become small, leading to blurred vision. This condition may also lead to a decrease in color perception.

  2. Diplopia: The person may experience double vision due to the swelling of the optic disc.

  3. Flashes: This condition may cause a transient visual disturbance that can look like flashes or flickering.

  4. Loss of Vision: The person may experience vision loss due to swelling of the optic nerve and the optic disc.

If the pressure in the brain increases or remains constant, it may be associated with other symptoms such as :

  1. Headache: This condition may be accompanied by a sudden headache that indicates an increase in intracranial pressure. The headache may be of a very serious nature. It may worsen on awakening and movements.

  2. Nausea and Vomiting: An increase in intracranial pressure can lead to severe nausea and vomiting. This may eventually lead to loss of consciousness and death.

  3. Tinnitus: The person may experience a ringing sensation in the ear.

What Are the Causes of Papilledema?

Papilledema mainly occurs when the optic nerve experiences pressure from the brain. This pressure could be exerted due to various reasons, such as tumors or any space-occupying lesions of the brain. This pressure on the optic nerve causes it to expand, leading to enlarged disc space or papilledema. The various causes of papilledema are:

  1. Tumors: Tumors of the brain can cause an increase in intracranial pressure as it is a space-occupying lesion. To compensate for the space demand, pressure inside the cranium increases, leading to papilledema.

  2. Intracranial Hypertension: Intracranial hypertension of unknown origin or idiopathic intracranial hypertension is one of the most common causes of papilledema. This form of hypertension leads to an increase in intracranial pressure leading to an increase in the disc space.

  3. Change in the Volume of Cerebrospinal Fluid (CSF): An increase or decrease in the volume of CSF can alter intracranial pressure. This fluctuation in the volume can be due to various factors such as a tumor, injury, or infection. This change in volume can ultimately lead to increased pressure in the disc space.

  4. Obstruction: Any obstruction in the vessels that supply the brain can cause increased intracranial pressure. This can ultimately result in papilledema.

  5. Encephalitis: A rise in intracranial pressure can be due to edema in the cranial cavity that may be caused due to various factors.

  6. Craniosynostosis: This is a condition wherein the skull or the cranium is smaller in size when compared to the brain. This mismatch in the size and shape of the brain and the skull can cause increased intracranial pressure that ultimately leads to papilledema.

  7. Medications: Certain medications such as Tetracycline, Minocycline, Doxycycline, lithium, antibiotics, and corticosteroids can cause papilledema.

  8. Head Injury: Any injury to the head can cause an increase in intracranial pressure. An injury to the head may also be associated with intracranial hemorrhage. This together causes intracranial pressure to increase, ultimately leading to papilledema.

  9. Blockage of CSF: Any blockage in the pathway of CSF can occur that can increase intracranial pressure.

  10. Hypervitaminosis-A: An increase in intracranial pressure can be caused by an excess of vitamin A.

  11. Obesity: Obesity can act as an important causative factor for an increase in intracranial hypertension, which can ultimately result in papilledema.

  12. Guillain-Barre Syndrome: It is an autoimmune disorder of the nervous system which has a sudden onset. This causes an increase in intracranial pressure and, ultimately, papilledema.

What Are the Complications of Papilledema?

Papilledema can lead to various complications, such as:

  1. Papilledema, if left untreated, can lead to total blindness.

  2. Brain damage.

  3. Stroke.

  4. Seizures.

  5. Severe recurring headache.

How to Diagnose Papilledema?

  1. Physical examination of the eye can be done using an ophthalmoscope. This aids in studying the optic disc and optic nerve. The initial physical examination can aid in the detection of papilledema.

  2. If physical examination denotes papilledema, the doctor may advise investigations such as an MRI (magnetic resonance imaging) or CT (computed tomography) scan to find the underlying causative factor.

  3. Sometimes a blood or CSF investigation may also be needed.

How to Treat Papilledema?

Treatment of papilledema depends on the causative factor. Resolution of the causative factor can cause the papilledema to resolve.

  1. In case of an increase in intracranial pressure due to a change in the CSF volume, the extra volume may be drained to decrease the intracranial pressure.

  2. If papilledema occurs due to hypertension, medications and diet may be prescribed to reduce intracranial pressure.

  3. If obesity is the causative factor, the doctor may ask the patient to lose weight through exercise and diet or through surgical means like bariatric surgery.

  4. If the intracranial pressure increases due to pathologies like tumors, after necessary diagnostic procedures, appropriate treatment can be given. This may include surgery and other treatments like chemotherapy and radiotherapy.

  5. In the case of papilledema due to head injury, this condition can be resolved after following the necessary protocols and treatments.


Papilledema is not a condition of its own; it is an outcome of the underlying causative factors. Upon resolution of these underlying conditions or pathologies, papilledema can be cured. However, this condition is not to be taken lightly, and immediate medical care should be taken for early resolution and to prevent complications.

Frequently Asked Questions


What Is the Cure for Papilledema?

Papilledema can be treated by ruling out any life-threatening cause of papilledema. Then, treating by weight loss and diuretics. Diuretics help reduce the pressure inside the head by lessening the fluid inside the body and fluid in the brain.


How Does One Differentiate Between Optic Disc Edema and Papilledema?

Optic disc edema occurs due to optic neuropathy of any etiology, like infiltrative, inflammatory, compressive, etc. In optic disc edema, swelling may be seen in the nerve fiber layer at the optic nerve head. In the case of papilledema, optic disc edema is caused due to raised intracranial pressure.


Is Papilledema a Type of Brain Tumor?

No, It is an indicator of raised intracranial pressure. It rarely appears among individuals with brain tumors nowadays. This is because of the widespread availability of modern neuroimaging techniques. These techniques are used to identify the brain tumors before the papilledema develops.


What Are the Early Signs of Papilledema?

Papilledema does not show any symptoms in the early stage. It can be detected during a routine eye examination. Healthcare providers may observe swelling in the optic nerve during the examination.


Does Papilledema Is Considered a Serious Condition?

Yes, papilledema is considered to be a serious issue because it may affect the eyes. Vision problems may be observed in this condition in both eyes. This condition must be treated as early as possible.


What Are the Different Stages of Papilledema?

Papilledema can be classified into stage 0 to stage 5 based on the Frisen scale. Stage 0 refers to the normal optic disc.

Stage 1: Refers C-shaped halo of disc edema with the preservation of the temporal disc.

Stage 2: Refers to the circumferential halo edema on the optic disc.

Stage 3: Refers to the elevated and blurred disc margin borders, and one or more major retinal segments gets obscured.

Stage 4: Refers to more pronounced than that of stage 3, and obscuration of a segment of the central retinal artery or vein.

Stage 5: Refers to the dome-shaped protrusions that represent the anterior expansion of the optic nerve head.


Does Excess Vitamin Causes Papilledema, and Which Vitamin?

Vitamin A and its metabolites are thought to cause papilledema. Vitamin A intoxication may cause idiopathic intracranial hypertension or papilledema. This condition may simulate acute encephalitis.


Which Drug Can Cause Papilledema?

Certain drugs like corticosteroids, Isotretinoin, Lithium, Tetracycline, and Nalidixic acid may cause papilledema. These drugs cause papilledema because of their side effects or when these drugs are stopped from being taken.


Mention the Risk Factors for Papilledema.

The risk factors for papilledema include space-occupying lesions like tumors, subarachnoid hemorrhage, decreased absorption of cerebrospinal fluid, change in the dynamics of cerebrospinal fluid flow through the ventricles, or due to increased production of cerebrospinal fluid.


What is another Term For Papilledema?

Papilledema is a term used to describe disc swelling caused due to increased intracranial pressure. When the optic disc swelling is due to other causes other than intracranial pressure, it may be termed optic disc edema.


What Symptoms Indicate Optic Nerve Damage?

The signs and symptoms of optic nerve damage include pain developed due to optic neuritis and may worsen during eye movement. Vision loss may be observed in one eye. Most individuals may experience a temporary reduction in vision, and vision loss may vary. There may be a loss of visual field and color vision. Flashing lights may be observed.


For What Duration Can Papilledema Last?

Papilledema of the mild version may last for months or years. At this stage, vision may not show significant change. If an individual starts to lose vision, it may become permanent within days or weeks. It needs to be treated immediately.


Can MRI Diagnose Papilledema?

Yes, Magnetic Resonance Imaging (MRI) can help with gross visualization of the optic globe, optic nerve protrusion, orbits, and optic tract. It can be used as an ideal tool to study the details of papilloedema.


Who Should Be Consulted For Papilledema?

Yes, ophthalmologist treatment for papilledema depends on the condition's specific cause. Treatment may be a procedure or medication. The treatment helps reduce the intracranial pressure in the optic discs.


Can Hypertension Lead to Papilledema?

Yes, In some rare cases, papilloedema may be caused due to increased blood pressure. This condition is referred to as a hypertensive crisis by healthcare providers. In this type of condition, it is necessary to reduce blood pressure to avoid harmful effects.

Dr. Shikha Gupta
Dr. Shikha Gupta

Ophthalmology (Eye Care)


bilateral papilledema
Community Banner Mobile
By subscribing, I agree to iCliniq's Terms & Privacy Policy.

Source Article ArrowMost popular articles

Do you have a question on

bilateral papilledema

Ask a doctor online

*guaranteed answer within 4 hours

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.

This website uses cookies to ensure you get the best experience on our website. iCliniq privacy policy