Which finding is NOT typically associated with papilledema?

Which finding is NOT typically associated with papilledema?

• A. Bilateral disc edema
• B. Severely reduced visual acuity
• C. Enlarged blind spot on the visual field
• D. Paton's lines temporal to the disc

Answer: (B)

Papilledema reflects raised intracranial pressure causing swelling of the optic nerve head, and it most commonly presents with bilateral disc edema while central visual acuity is usually preserved early. The swollen disc tends to blur margins and can be accompanied by temporary visual obscurations. An enlarged physiologic blind spot on the visual field is a classic accompanying finding because the swollen nerve head enlarges the area of nonseeing field. Paton’s lines are peripapillary nerve fiber layer folds that can appear as faint ridges around the disc, often seen in papilledema and typically oriented toward the temporal side. Severely reduced visual acuity, on the other hand, is not a typical early feature of papilledema; a significant drop in acuity would more strongly suggest another optic nerve pathology unless the edema is advanced or there are additional complicating factors.

Papilledema reflects raised intracranial pressure causing swelling of the optic nerve head, and it most commonly presents with bilateral disc edema while central visual acuity is usually preserved early. The swollen disc tends to blur margins and can be accompanied by temporary visual obscurations. An enlarged physiologic blind spot on the visual field is a classic accompanying finding because the swollen nerve head enlarges the area of nonseeing field. Paton’s lines are peripapillary nerve fiber layer folds that can appear as faint ridges around the disc, often seen in papilledema and typically oriented toward the temporal side. Severely reduced visual acuity, on the other hand, is not a typical early feature of papilledema; a significant drop in acuity would more strongly suggest another optic nerve pathology unless the edema is advanced or there are additional complicating factors.