What causes papilledema and how to treat it?

Symptom Database

Papilledema, also known as optic disc swelling, is a condition characterized by the swelling of the optic disc due to increased intracranial pressure. This increased pressure can lead to visual disturbances and other symptoms that can significantly impact a person’s eye health. Understanding the causes of papilledema and the available treatment options is crucial for managing this condition effectively.

Causes of Papilledema

Papilledema is primarily caused by increased intracranial pressure, which can result from various underlying conditions. Some of the common causes of papilledema include:

  • Intracranial hypertension: This condition occurs when there is an abnormal increase in the pressure within the skull. It can be caused by factors such as brain tumors, hydrocephalus, or cerebral edema.
  • Head trauma: Severe head injuries can lead to papilledema due to the disruption of normal cerebrospinal fluid flow and subsequent increased pressure.
  • Infections: Certain infections, such as meningitis or encephalitis, can cause inflammation and increased pressure within the skull, leading to papilledema.
  • Idiopathic intracranial hypertension: In some cases, the exact cause of papilledema may not be identified, and it is referred to as idiopathic intracranial hypertension. This condition primarily affects overweight women of childbearing age.

Symptoms of Papilledema

Papilledema can present with various symptoms, which may vary in severity depending on the underlying cause and the duration of the condition. Some common symptoms of papilledema include:

  • Visual disturbances: Patients may experience blurred vision, double vision, or even temporary vision loss.
  • Headaches: Persistent headaches, often worse in the morning or with changes in body position, can be a symptom of papilledema.
  • Nausea and vomiting: Increased intracranial pressure can cause nausea and vomiting.
  • Eye swelling: Swelling of the optic nerve can lead to eye swelling, which may be noticeable to the patient or their healthcare provider.
  • Changes in vision: Patients may experience changes in their peripheral vision or difficulty with visual fields.

Treatment for Papilledema

The treatment for papilledema primarily focuses on addressing the underlying cause and reducing intracranial pressure. Prompt diagnosis and management are essential to prevent further damage to the optic nerve and preserve vision. Some treatment options for papilledema include:

Medical Management

Medical management aims to reduce intracranial pressure and manage the symptoms associated with papilledema. This may involve:

  • Diuretics: Medications that increase urine production can help reduce fluid retention and lower intracranial pressure.
  • Corticosteroids: These anti-inflammatory medications can be used to reduce swelling and inflammation within the brain.
  • Medications to control underlying conditions: If an underlying condition, such as a brain tumor or infection, is causing papilledema, specific medications may be prescribed to address the primary cause.

Surgical Interventions

In some cases, surgical interventions may be necessary to alleviate the increased intracranial pressure and manage papilledema effectively. These interventions may include:

  • Optic nerve sheath fenestration: This procedure involves creating a small opening in the optic nerve sheath to relieve pressure and reduce swelling.
  • Ventriculoperitoneal shunt: In cases where hydrocephalus is causing papilledema, a shunt may be surgically placed to drain excess cerebrospinal fluid and relieve pressure.
  • Tumor removal: If a brain tumor is causing papilledema, surgical removal of the tumor may be necessary to alleviate the pressure on the optic nerve.

It is important to note that the treatment approach for papilledema may vary depending on the underlying cause and the individual patient’s condition. Therefore, it is crucial to consult with a neuro-ophthalmologist or an eye specialist experienced in managing papilledema to determine the most appropriate treatment plan.


Papilledema, characterized by optic disc swelling and increased intracranial pressure, can have significant implications for a person’s eye health and vision. Understanding the causes and symptoms of papilledema is crucial for early detection and prompt management. With appropriate medical or surgical interventions, it is possible to alleviate the increased intracranial pressure and preserve vision. If you experience any visual disturbances or other symptoms associated with papilledema, it is essential to seek medical attention promptly to receive an accurate diagnosis and appropriate treatment.

Haroon Rashid, MD
Rate author
Urgent Care Center of Arlington, VA
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