Medical Subject Headings
Papilledema; Intracranial Hypertension; Optic Nerve; Retina; Scanning Laser Ophthalmoscopy; Fundus Autofluorescence; Visual Acuity; Visual Fields; Afferent Pupillary Defect; Contraceptives, Oral; Topiramate; Adolescent; Case Reports
Abstract
Background: Papilledema, optic disc swelling secondary to elevated intracranial pressure (ICP), is a medical emergency given the gravity of possible disease etiologies, including but not limited to intracranial mass.
Case Report: A 12-year-old female with normal body mass index developed marked headaches and subsequently manifested bilateral swelling of the optic discs and retinal folds. Scanning laser ophthalmoscopy, particularly in the fundus autofluorescence mode, provided a striking image of the retinal folds. The posterior segment abnormalities were accompanied by reduced visual acuity and corresponding visual field defects. The edema of the optic nerve and retinal fluid were worse in her left eye causing a greater reduction in vision and a positive afferent pupil defect OS. The clinical diagnosis was papilledema although it was never confirmed as such due to irregularities in the medical testing.
Conclusion: Case analysis led to a conclusion that oral contraceptive medication triggered the papilledema and discontinuation of the oral contraceptive medication and initiation of oral topiramate medication resolved it.
Recommended Citation
Tassinari JD, Kwok P. A Case of Adolescent Papilledema Secondary to Oral Hormonal Contraceptives. Optometric Clinical Practice. 2026; 8(1):5. https://doi.org/10.37685/uiwlibraries.2575-7717.8.1.1047
Figure showing visual fields
Figure 2 Imaging Final.docx (2736 kB)
Figure showing all fundus imaging
Table 1 final.docx (12 kB)
Table showing case chronology
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Digital Object Identifier (DOI)
10.37685/uiwlibraries.2575-7717.8.1.1047