Manual

Papilledema & IIH

Vision Loss

Papilledema & IIH

Bilateral disc edema from raised ICP.

  1. 1Check BP (exclude malignant hypertension).
  2. 2Urgent MRI brain with MRV to exclude mass and venous sinus thrombosis.
  3. 3Lumbar puncture with opening pressure (> 25 cm H₂O in adults) and CSF analysis.
  4. 4Formal visual fields (enlarged blind spot, nasal step) and OCT RNFL to monitor.

IIH treatment: weight loss (5–10%), acetazolamide (IIHTT), GLP-1 agonists increasingly used; optic nerve sheath fenestration, venous sinus stenting or CSF shunting for fulminant disease.

Educational summary — follow local protocols and current guidelines.