Papilledema or Retinal Hemorrhage

Papilledema is swelling that occurs in the inner, back region of the eye where nerve fibers transmit images from the optic nerve to the brain. Papilledema tends to occur in both eyes when pressure begins to build within the skull.

Causes

Papilledema is caused by an increase in the pressure of the fluid (cerebrospinal fluid) that is present between the brain and the skull, inside the head, this increased pressure is transmitted through to the optic nerve. The brain itself is relatively spared from pathological consequences of high pressure. However, the anterior end of the optic nerve stops abruptly at the eye. Hence the pressure is asymmetrical and this causes a pinching and protrusion of the optic nerve at its head. The fibers of the retinal ganglion cells of the optic disc become engorged and bulge anteriorly. Persistent and extensive optic nerve head swelling, or optic disc edema, can lead to loss of these fibers and permanent visual impairment.

Symptoms

• Headache and visual loss are frequent.
• No symptoms may be reported.

Signs

• Abnormal funduscopic examination
• Hypertension
• Other signs of other end-organ damage

Treatment

Treatment of papilledema is generally aimed at the treatment of the underlying disorder that is causing papilledema.

Diuretic drugs combined with a weight reduction program may be useful in cases of papilledema that are caused by an abnormally high production of cerebrospinal fluid.

Corticosteroids have been shown to be effective in relieving the symptoms in some patients with papilledema caused by inflammatory disorders.