Pseudopapilledema

A diagnostic dilemma often arises when a patient with headaches is found to have optic nerve head elevation. In this chapter, we begin by reviewing the potential causes of optic nerve head elevation, which include papilledema, optic disc edema from another cause, optic nerve head infiltration, and anomalous optic nerve head elevation that mimics optic disc edema (pseudopapilledema). We next list the common causes of pseudopapilledema and discuss strategies that help to distinguish pseudopapilledema from papilledema. We then review the clinical features and diagnostic evaluation of optic nerve head drusen, a common cause of pseudopapilledema, and describe ophthalmic imaging techniques that can help to distinguish optic nerve head drusen from papilledema.