A woman in her 30s was referred for evaluation of bilateral papilledema. She had no specific chief complaint other than intermittent floaters. A review of systems as well as her medical, family, and social history were unremarkable. She was not taking any medications and did not have any allergies. Best-corrected visual acuity was measured 20/25 OD and 20/20 OS. Extraocular movements were intact and pupils were round and reactive with no afferent pupillary defect. Intraocular pressure by applanation was 18 mm Hg OU. Her anterior segment examination was within normal limits. Examination of her fundus revealed the optic nerves seen in Figure 1. The remainder of her posterior segment was unremarkable.
Zhu I, Francis AW, Cortina MS. Abnormal Optic Nerves in a Healthy Young Woman. JAMA Ophthalmol. 2016;134(12):1435–1436. doi:10.1001/jamaophthalmol.2016.2134
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