Grade I : papilledema is characterized by a C-shaped halo with a temporal gap.
Grade II : papilledema, the halo becomes circumferential.
Grade III : papilledema is characterized by loss of major vessels as they leave the disc (arrow).
Grade IV : papilledema is characterized by loss of major vessels on the disc.
Grade V : papilledema has the criteria of grade IV plus partial or total obscuration of all vessels of the disc.
Findings: disc edema (may be asymmetric); loss of
spontaneous venous pulsations (absent in 20% of normals);
transient visual obscurations (visual blackouts lasting <10
seconds associated with postural changes); diplopia (due to
unilateral or bilateral CN 6 palsies); normal color vision,
acuity, and pupils; enlarged blind spot on VF; headache,
Chronic cases: pale atrophic nerve, arteriolar attenuation,
poor vision, VF loss, refractile small hyaline bodies on
DD: intracranial tumor (posterior fossa in children),
meningitis, carcinomatous meningitis, pseudotumor cerebri.
Diagnosis: check blood pressure; brain CT,MRI, if no
mass, perform lumbar puncture (measure opening pressure)