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Consultant Ophthalmologist,
Cataract & Refractive Surgeon

BMedSci BM BS MRCS MRCSEd MRCOpth FRCOphth MMedLaw PgD Cataract & Refractive Surgery


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What's going on?

The disc looks swollen but in fact is normal. The phenomenon can be related to buried optic nerve head drusen or to the appearance of the disc in a markedly long-sighted (hypermetropic) eye.

If I examine the patient, what will I find?

The disc will look swollen.

What if I've diagnosed it?

The patient should be referred to exclude true papilloedema.

What will the hospital do?

Sometimes an ultrasound scan will be carried out to look for a highly reflective disc consistent with disc drusen. A fluorescein angiogram can be the only way to tell whether the disc is truly swollen, however. A swollen disc will leak fluorescein.

What do I need to do?

Check for any associated neurological features that may contribute to the diagnosis – these will be absent in pseudopapilloedema.

What to tell the patient

If pseudopapilloedema is confirmed, the patient can be reassured that the eye is normal. However, if they are having a check-up for the first time with a new optician, they should explain the situation to avoid being wrongly referred to hospital.