The basic difference between papilledema due to increased intracranial pressure (hereafter referred to as papilledema) and papillitis (the intraocular form of optic neuritis) was first described by Paton and Holmes1 in 1911. Since then there have been various other references to the same subject in the literature.2-5 The outstanding features which distinguish the two entities are concerned with the type of pain as well as the type of visual impairment. The funduscopic picture as well as the laterality of the findings are also of importance. For purposes of this paper, these well-known points will be reviewed very briefly.
Pain
In optic neuritis the pain is in or behind the eye and increases with movement of or pressure on the globe. It either precedes the visual disturbance or accompanies it. In papilledema the pain is that of a generalized headache usually preceding the appearance of papilledema by a considerable