Papilledema

Papilledema, also known as choked disk, refers to swelling of the optic disc caused by elevated intracranial pressure (ICP). This condition must be distinguished from disc edema, which encompasses a broader category of optic disc swelling secondary to various local or systemic etiologies. Recent reviews have highlighted frequent misuse of the term “papilledema” when describing optic disc edema (ODE) unrelated to ICP elevation. Papilledema specifically denotes ODE secondary to raised ICP and represents a primary indication for referral to neuro-ophthalmologists. Accurate differentiation from other causes of ODE in any specialty setting is essential, as papilledema involves a distinct pathophysiology and management strategy, with inappropriate management potentially resulting in permanent vision loss. ICP elevation may occur without visible optic disc swelling. Papilledema typically presents bilaterally but may appear asymmetrically and, rarely, unilaterally. This sign may indicate serious conditions that increase ICP, including brain tumors, infectious or noninfectious cerebrospinal inflammation, and idiopathic intracranial hypertension (IIH).