Differential Diagnosis

Pseudoneuritis or pseudo-papilloedema is a condition occurring usually in hypermetropic individuals when the lamina cribrosa is small and the crowded nerve fibres are heaped up as they entre the nerve head from the surrounding retina. Optic disc drusen are a major source of confusion and should be considered when disc swelling is not associated with any visual disturbance or symptoms of raised intracranial pressure. It occurs in families, is typically bilateral and inherited as an irregular dominant trait. Ischeamic optic neuropathy: This usually produces profound, sudden viual loss and could be either arteritic type associated with giant cell arteritis, or non arteritic, associated with vasculopathies.The swollen disc has a characteristically pallid appearance in eithertypes and in some patients can be localized to one sector of the disc with hyperemia of the remaining portions. Optic neuritis due to inflammation (Papillitis).Here, the appearance of the disc is often indistinguishable from that in papillaoedema. Orbital lesions and disc oedema: Rarely conditions causing stasis in the orbit may produce disc oedema-e.g. tumors of the optic nerve etc.