eMedicine Specialties > Ophthalmology > Optic Nerve

Pseudopapilledema: Treatment & Medication

Author: Mitchell V Gossman, MD, Partner and Vice President, Eye Surgeons and Physicians, St Cloud
Coauthor(s): Joseph Giovannini, MD, Chief of Ophthalmology, Eye Surgery Center, David Grant Medical Center, Travis Air Force Base
Contributor Information and Disclosures

Updated: Dec 10, 2008

Treatment

Medical Care

  • No treatment is needed for most causes of pseudopapilledema because they represent normal physiologic variants.
  • Diseases possibly associated with disc drusen may need treatment, such as subretinal neovascular membrane, central retinal vein occlusion, or ischemic optic neuropathy (largely to exclude giant cell arteritis in the appropriate age groups).
  • A minority of patients with disc drusen (16-22%) present with progressive visual loss. Field deterioration normally occurs over many years and is generally slow and unnoticed by patients. Dramatic field loss related to vascular complications, such as anterior ischemic optic neuropathy, can rarely occur. Unfortunately, no successful therapy is available at this time.
  • For patients who may suffer from glaucoma, it can be challenging to differentiate progressive glaucomatous field loss from field loss due to glaucoma. Estimation of the cup-to-disc ratio is also more challenging.1

Surgical Care

No effective surgical treatment is available.

More on Pseudopapilledema

Overview: Pseudopapilledema
Differential Diagnoses & Workup: Pseudopapilledema
Treatment & Medication: Pseudopapilledema
Follow-up: Pseudopapilledema
Multimedia: Pseudopapilledema
References
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References

  1. Grippo TM, Shihadeh WA, Schargus M, Gramer E, Tello C, Liebmann JM, et al. Optic nerve head drusen and visual field loss in normotensive and hypertensive eyes. J Glaucoma. Mar 2008;17(2):100-4. [Medline].

  2. Acheson JF, Sanders MD. Common Problems in Neuro-ophthalmology. 1997;78-84.

  3. Auw-Haedrich C, Staubach F, Witschel H. Optic disk drusen. Surv Ophthalmol. Nov-Dec 2002;47(6):515-32. [Medline].

  4. Cullom RD, Chang B. The Wills Eye Manual. 1994;270-272.

  5. Kline LB. Optic Nerve Disorders. 1996;37-53.

  6. Miller NR, Newman NJ. Clinical Neuro-Ophthalmology - The Essentials. 1999;166-195.

  7. Vaphiades MS. The disk edema dilemma. Surv Ophthalmol. Mar-Apr 2002;47(2):183-8. [Medline].

  8. Yanoff M, Duker JS. Ophthalmology. 1999;11.5.1-5.4.

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Further Reading

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Keywords

pseudopapilledema, papilledema, optic disc drusen, optic disc swelling

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Contributor Information and Disclosures

Author

Mitchell V Gossman, MD, Partner and Vice President, Eye Surgeons and Physicians, St Cloud
Mitchell V Gossman, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, American Medical Association, American Society of Cataract and Refractive Surgery, Minnesota Medical Association, North American Neuro-Ophthalmology Society, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Coauthor(s)

Joseph Giovannini, MD, Chief of Ophthalmology, Eye Surgery Center, David Grant Medical Center, Travis Air Force Base
Joseph Giovannini, MD is a member of the following medical societies: American Academy of Ophthalmology and American Society of Cataract and Refractive Surgery
Disclosure: Nothing to disclose.

Medical Editor

Edsel Ing, MD, FRCSC, Assistant Professor, Department of Ophthalmology & Vision Sciences, University of Toronto: Consulting Staff, Toronto East General Hospital
Edsel Ing, MD, FRCSC is a member of the following medical societies: American Academy of Ophthalmology, American College of Physician Executives, American Society of Contemporary Ophthalmology, Canadian Ophthalmological Society, Contact Lens Association of Ophthalmologists, North American Neuro-Ophthalmology Society, and Royal College of Physicians and Surgeons of Canada
Disclosure: Nothing to disclose.

Pharmacy Editor

Simon K Law, MD, PharmD, Assistant Professor of Ophthalmology, Jules Stein Eye Institute; Chief of Section of Ophthalmology Surgical Services, Department of Veterans Affairs Healthcare Center, West Los Angeles
Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Managing Editor

Brian R Younge, MD, Professor of Ophthalmology, Mayo Clinic School of Medicine
Brian R Younge, MD is a member of the following medical societies: American Medical Association, American Ophthalmological Society, and North American Neuro-Ophthalmology Society
Disclosure: Nothing to disclose.

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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