Papilledema pathophysiology

Papilledema
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-In-Chief:Kalsang Dolma

Pathophysiology

• Optic nerve sheath is continuous with the subarachnoid space of the brain and is regarded as an extension of the central nervous system.

• The brain itself is relatively spared from pathological consequences of high pressure.

• Increased intracranial pressure is transmitted through to the optic nerve via this optic nerve sheath.

• 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.