Table 7-13 Abnormalities of the Optic Disc

Papilledema

PROCESS Elevated intracranial pressure causes intraaxonal edema along the optic nerve, leading to engorgement and swelling of the optic disc APPEARANCE color pink, hyperemic Often with loss of venous pulsations Disc vessels more visable, more numerous, curve over the borders of the disc Disc swollen with margins blurred The physiologic cup is not visible Seen in intracranial mass, lesion, or hemorrhage, meningitis

Glaucomatous Cupping

PROCESS Increased intraocular pressure within the eye leads to increased cupping (backward depression of the disc) and atrophy. The base of the enlarged cup is pale. APPEARANCE Death of optic nerve fibers leads to loss of the tiny disc vessels.

Optic Atrophy

PROCESS The physiologic cub is enlarged, occupying more than half of the disc's diameter, at times extending to the edge of the disc. Retinal vessels sink in and under the cup, and may be displaced nasally. APPEARANCE Color white Tiny disc vessels absent Seen in optic neuritis, multiple sclerosis, temporal arteritis

Normal

PROCESS Tiny vessels give normal color to the disc APPEARANCE Color yellowish orange to creamy pink Disc vessels tiny Disc margins sharp (except perhaps nasally) The physiologic cub is located centrally or somewhat temporally. It may be conspicuous or absent. its diameter from side to side is usually less than half that of the disc.