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On examination, her distance best-corrected visual acuity was counting fingers at 1 m in the RE and 20\/20 in the left eye (LE). Colour vision was subnormal in both eyes (BE). There was grade II relative afferent pupillary defect in the RE. Fundus examination showed disc oedema in BE . Visual fields in the LE showed central scotoma extending nasally. A provisional diagnosis of papillitis was considered. However, contrast-enhanced MRI of the brain and orbits showed evidence of elevated intracranial pressure. Cerebrospinal fluid (CSF) opening pressure was 42\u2009cm H<jats:sub>2<\/jats:sub>O while rest of the CSF analysis was normal. Diagnosis was revised to fulminant idiopathic intracranial hypertension. Management with medical therapy and urgent thecoperiteoneal shunt improved visual function in BE.<\/jats:p>","DOI":"10.1136\/bcr-2020-236188","type":"journal-article","created":{"date-parts":[[2020,11,4]],"date-time":"2020-11-04T16:35:55Z","timestamp":1604507755000},"page":"e236188","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Rapidly progressive vision loss due to fulminant idiopathic intracranial hypertension: a diagnostic and management dilemma"],"prefix":"10.1136","volume":"13","author":[{"given":"Jagadeesh","family":"Sutraye","sequence":"first","affiliation":[{"name":"Department of Pediatric Ophthalmology, Strabismus and Neruo-Ophthalmology, Child Sight Institute, Nimmagadda Prasad Children's Eye Care Centre, LV Prasad Eye Institute, GMRV Campus, Visakhapatnam, Andhra Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohan","family":"Kannam","sequence":"additional","affiliation":[{"name":"Department of Pediatric Ophthalmology, Strabismus and Neruo-Ophthalmology, Child Sight Institute, Nimmagadda Prasad Children's Eye Care Centre, LV Prasad Eye Institute, GMRV Campus, Visakhapatnam, Andhra Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajat","family":"Kapoor","sequence":"additional","affiliation":[{"name":"Department of Pediatric Ophthalmology, Strabismus and Neruo-Ophthalmology, Child Sight Institute, Nimmagadda Prasad Children's Eye Care Centre, LV Prasad Eye Institute, GMRV Campus, Visakhapatnam, Andhra Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1927-6643","authenticated-orcid":false,"given":"Virender","family":"Sachdeva","sequence":"additional","affiliation":[{"name":"Department of Pediatric Ophthalmology, Strabismus and Neruo-Ophthalmology, Child Sight Institute, Nimmagadda Prasad Children's Eye Care Centre, LV Prasad Eye Institute, GMRV Campus, Visakhapatnam, Andhra Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,11,4]]},"reference":[{"key":"2025082709032022000_13.11.e236188.1","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000109042.87246.3C"},{"key":"2025082709032022000_13.11.e236188.2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3182a55f17"},{"key":"2025082709032022000_13.11.e236188.3","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1001\/jamaneurol.2014.133","article-title":"The idiopathic intracranial hypertension treatment trial: clinical profile at baseline","volume":"71","author":"Wall","year":"2014","journal-title":"JAMA Neurol"},{"key":"2025082709032022000_13.11.e236188.4","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2011-302029"},{"key":"2025082709032022000_13.11.e236188.5","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000251312.19452.ec"},{"key":"2025082709032022000_13.11.e236188.6","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.190024"},{"key":"2025082709032022000_13.11.e236188.7","first-page":"47","article-title":"Papilledema: epidemiology, etiology, and clinical management","volume":"7","author":"Rigi","year":"2015","journal-title":"Eye Brain"},{"key":"2025082709032022000_13.11.e236188.8","doi-asserted-by":"publisher","DOI":"10.1007\/s00417-006-0494-0"},{"key":"2025082709032022000_13.11.e236188.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.survophthal.2009.06.008"},{"key":"2025082709032022000_13.11.e236188.10","doi-asserted-by":"crossref","first-page":"443","DOI":"10.3171\/jns.1989.71.3.0443","article-title":"Malignant pseudotumor cerebri. 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