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August 1952

PAPILLEDEMA: Its Differential Diagnosis, with Special Reference to Minimal Testing of the Blind Spot at Two Meters

Author Affiliations


From the Neurosurgical and Ophthalmological Services of the Mount Sinai Hospital.

AMA Arch NeurPsych. 1952;68(2):213-232. doi:10.1001/archneurpsyc.1952.02320200051007

BEFORE describing the fundus conditions simulating papilledema, it is advantageous to discuss the important clinical features of papilledema that will be used as criteria. In using the term "papilledema," we limit ourselves in this paper to the edema of the optic disk due to increased intracranial pressure. The clinical features will be discussed under the following headings: (1) appearance of the fundus; (2) the normal blind spot; (3) histological appearance in papilledema and mode of effect on the blind spot; (4) visual impairment due to papilledema; (5) differences in responses of various optic disks to increased intracranial pressure.

APPEARANCE OF FUNDUS IN PAPILLEDEMA  Typical, well-developed papilledema usually offers no challenge to the trained observer. Bilateral congestion of the optic disks, with obscuration of the disk margins, loss of the physiological cups, and fullness of the veins, together with hemorrhages and exudates confined to the disk and its immediate neighborhood, constitute

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