The Swollen Optic Disc in Childhood

Abstract

Because of its potentially ominous implications, the discovery of optic disc elevation in a child is a cause for urgent neuro-ophthalmologic referral. The nature of the underlying disorder can often be predicted from the wording of the referring physician’s telephone call. Bilateral optic disc elevation without visual loss in a child with headaches, nausea, and vomiting of several months duration creates a high index of suspicion for papilledema (i.e., swelling of the optic discs secondary to elevated intracranial pressure). Blurring of the nasal disc margins that is noted as an incidental finding in an otherwise healthy child is usually found to be pseudopapilledema (i.e., real or apparent elevation of the optic discs due to local structural factors that simulates swelling of the discs). Optic disc swelling in the setting of acute visual loss usually signifies optic neuritis.