Papilledema
- Stage 0 - Normal Optic Disc
a. Blurring of nasal, superior and inferior poles in Inverse proportion to disc diameter
a. Blurring of nasal, superior and inferior poles in Inverse proportion to disc diameter
b. RNFL without NFL tortuosity
c. Rare obscuration of a major blood vessel, usually on the upper pole
- Stage 1 - Very Early Papilledema
a. Obscuration of the nasal border of the disc
b. No elevation of the disc borders
c. Disruption of the normal radial NFL arrangement with greyish opacity accentuating NFL bundles
d. Normal temporal margin disc
e. Subtle grayish halo with temporal gap (best seen with indirect ophthalmoscopy)
f. Concentric or radial retrochoroidal folds
- >Stage 2 - Early Papilledema
a. Obscuration of all borders
b. Elevation of the nasal border
c. Complete peripapillary halo
- Stage 3- Moderate Papilledema
a. Obscurations of all borders
b. Increased diameter of optic nerve head
c. Obscuration of one or more segments of major blood Vessels leaving the disc
d. Peripapillary halo irregular outer fringe with finger-like extensions
-Stage 4 - Marked Papilledema
a. Elevation of the entire nerve head
b. Obscuration of all borders
c. Peripapillary halo
d. Total obscuration on the disc of a segment of a major blood vessel
-Stage 5 - Severe Papilledema
a. Dome-shaped protrusions representing anterior expansion of the optic nerve head
b. Peripapillary halo is narrow and smoothly demarcated
c. Total obscuration of a segment of a major blood vessel may or may not be present
d. Obliteration of the optic cup
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