OD WIRE WEEKEND 5/6 APRIL

[Lorcan Butler]

Hey guys looking forward to engaging with fellow ODs abut all things Papilledema and Pseudopapilledema. My presentation will be on a week today . But happy to start conversations, share clinical tips and also learn from each other also.

Any body got any recent patients or cases in practice that they would like to share about the presentations, findings and management .

Editor's note: Take advantage interacting with one of CEwire2025 International speakers. Be aware of the time zone difference USA/Canada and Belfast, UK.

 

[Lloyd Pate]

Hey guys looking forward to engaging with fellow ODs abut all things Papilledema and Pseudopapilledema. My presentation will be on a week today . But happy to start conversations, share clinical tips and also learn from each other also.

Any body got any recent patients or cases in practice that they would like to share about the presentations, findings and management .

One of the many things I hate about neuro-ophth is the fact that there are so many exceptions to the rule.

We all look for papilledema in diagnosing increased intracranial pressure, but it is so unreliable. 4% of patients can have unilateral papilledema, and 6% of adults and 48% of children with increased intracranial pressure have no papilledema.

History and the absence of symptoms can also fool you. I have had patients with markedly increased ICP and no symptoms. How do we catch the papients with increased intracranial pressure and no symptoms or papilledema?

 

[Lorcan Butler]

One of the many things I hate about neuro-ophth is the fact that there are so many exceptions to the rule.

We all look for papilledema in diagnosing increased intracranial pressure, but it is so unreliable. 4% of patients can have unilateral papilledema, and 6% of adults and 48% of children with increased intracranial pressure have no papilledema.

History and the absence of symptoms can also fool you. I have had patients with markedly increased ICP and no symptoms. How do we catch the papients with increased intracranial pressure and no symptoms or papilledema?

yes totally agree 100% Lloyd. By utilising as many multi modal imaging techniques as possible. And with your vast experience in this area there is a little bit of intuition and gut instinct also. Pediatric patients do Visual Fields also. thanks for contributing and sharing your wealth of experience .

 

[Lloyd Pate]

yes totally agree 100% Lloyd. By utilising as many multi modal imaging techniques as possible. And with your vast experience in this area there is a little bit of intuition and gut instinct also. Pediatric patients do Visual Fields also. thanks for contributing and sharing your wealth of experience .

I have a high number of pediatric cases because most neuo-ophth MDs don't see kids. 7 yo kids can do better fields than adults, but sometimes those don't catch the increased ICP. I run a wide range of OCT and OCTa scans on my patients. You are right that you have to trust your gut.