Skip to main content
Consultant Ophthalmologist, Cataract & Refractive Surgeon
BMedSci BM BS MRCS MRCSEd MRCOpth FRCOphth MMedLaw PgD Cataract & Refractive Surgery

Your patient has a swollen disc

Is the vision reduced? If so, consider an ischaemic optic neuropathy or an optic neuritis. Does the patient have GCA? – (check ESR and CRP). If the vision is not reduced, then either this is pseudo disc swelling (the appearance of disc swelling without true disc swelling) or the patient has papilloedema and requires urgent investigation for raised intracranial pressure. If the disc swelling is unilateral and vision normal, refer the patient urgently via letter to the hospital eye service. If the vision is reduced and the disc swollen, refer urgently. If the disc swelling is bilateral and the vision normal (papilloedema), refer to a physician to exclude raised intracranial pressure secondary to a space-occupying lesion. If the physician is unsure whether the discs are indeed swollen, he or she may refer directly to the ophthalmologist.