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Acute Optic Disc Edema

Acute optic disc edema

The optic disc is elevated and its surface is covered by cotton wool spots and flame hemorrhages. The cotton wool spots reflect explosion of damaged axons; the flame hemorrhages reflect explosion of vessels under pressure.

Although blurred optic disc margins and disc elevation can also be caused by a congenital optic disc anomaly, the cotton wool spots and hemorrhages tell you the disorder is acquired.

Optic disc edema is commonly caused by the four "I's":

  • increased intracranial pressure (papilledema)
  • infarction
  • inflammation
  • infiltration (by cancer)
Compression and toxins are other causes. You cannot differentiate one cause of optic disc edema from another on the basis of its ophthalmoscopic appearance! You must use non-ophthalmoscopic information, such as visual acuity or visual field defect, to make that distinction.

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