{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T06:24:58Z","timestamp":1790144698771,"version":"4.0.1"},"reference-count":51,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Pract Neurol"],"accepted":{"date-parts":[[2025,12,21]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:p>Papilloedema is optic disc swelling due to raised intracranial pressure (ICP). Typically, this occurs bilaterally, and visual function is usually relatively preserved unless the disease is moderately severe or chronic. The implications of a new finding of papilloedema are potentially serious; however, overdiagnosis of papilloedema can lead to iatrogenic harm from unnecessary investigation or treatment. It is important to consider the differential diagnosis for swollen optic disc appearances to ensure patients are investigated appropriately. We describe an approach to the clinical assessment of patients with suspected papilloedema, using history, examination and tools available in the eye clinic including perimetry and optical coherence tomography, as well as the pitfalls that may be encountered using these technologies. We also discuss a strategy for subsequent investigation of patients with probable papilloedema to identify causes of raised ICP, while highlighting potential pitfalls in this process.<\/jats:p>","DOI":"10.1136\/pn-2025-004784","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T18:20:25Z","timestamp":1768328425000},"page":"319-330","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["How to diagnose papilloedema"],"prefix":"10.1136","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5712-3800","authenticated-orcid":false,"given":"Michael C","family":"Lowe","sequence":"first","affiliation":[{"name":"Department of Neurology, Institute of Neurological Sciences, Glasgow, Scotland, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3390-9508","authenticated-orcid":false,"given":"Gabriele","family":"Berman","sequence":"additional","affiliation":[{"name":"Birmingham Neuro-ophthalmology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Labella \u00c1lvarez","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital Zurich, Z\u00fcrich, Switzerland"},{"name":"Department of Morphological and Socio-Sanitary Sciences, University of Cordoba, C\u00f3rdoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pushkar","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Neurology, Institute of Neurological Sciences, Glasgow, Scotland, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6314-4437","authenticated-orcid":false,"given":"Susan P","family":"Mollan","sequence":"additional","affiliation":[{"name":"Ophthalmology Department, Queen\u2019s University, Kingston, Ontario, Canada"},{"name":"Metabolic and Systems Science, University of Birmingham College of Medical and Dental Sciences, Birmingham, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,1,13]]},"reference":[{"key":"2026071405250908000_26.4.319.1","doi-asserted-by":"publisher","DOI":"10.1136\/pn-2025-004560"},{"key":"2026071405250908000_26.4.319.2","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1212\/cont.0000000000001556","article-title":"Papilledema","volume":"31","author":"Mollan","year":"2025","journal-title":"Continuum (Minneap Minn)"},{"key":"2026071405250908000_26.4.319.3","doi-asserted-by":"publisher","DOI":"10.1136\/practneurol-2012-000270"},{"key":"2026071405250908000_26.4.319.4","doi-asserted-by":"publisher","DOI":"10.1136\/practneurol-2018-002057"},{"key":"2026071405250908000_26.4.319.5","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1962.03050290013003"},{"key":"2026071405250908000_26.4.319.6","doi-asserted-by":"crossref","first-page":"2157","DOI":"10.1038\/s41433-022-02310-0","article-title":"Impact of the COVID-19 pandemic and Honey Rose case on hospital attendances of patients suspected to have papilloedema","volume":"37","author":"McNicholl","year":"2023","journal-title":"Eye"},{"key":"2026071405250908000_26.4.319.7","doi-asserted-by":"crossref","unstructured":"Biousse V , Newman N , eds. 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