Kurnia Meiga, a former Indonesian national soccer team goalkeeper, recently received public attention for his poor health condition. He was diagnosed with papilledema, a disease of eye nerve swelling that can cause blindness.
Papilledema is a condition in which the optic nerve of the eye swells due to increased intracranial pressure (ICP)⁴. Intracranial pressure is the pressure that occurs inside the skull due to the presence of fluid or mass that presses on the brain.
The optic nerve is a bundle of nerve fibers that carry visual information from the retina to the brain. The optic disc is the area where the optic nerve enters the back of the eye. If the optic nerve swells, then the blood and oxygen flow to the optic nerve will be disrupted, which can damage the visual function.
What causes papilledema?
The causes of papilledema can vary, depending on what causes the intracranial pressure to increase. Some common causes are:
- Brain tumor, benign or malignant⁴.
- Brain or meningeal infection, such as meningitis or encephalitis⁴.
- Brain hemorrhage or stroke⁴.
- Hydrocephalus, which is a buildup of fluid in the brain cavities⁴.
- Pseudotumor cerebri syndrome, which is an increase in intracranial pressure without any clear cause or mass lesion⁴.
What are the symptoms of papilledema?
The symptoms of papilledema can vary, depending on the severity and cause. However, in general, the symptoms of papilledema include:
- Severe headache that worsens when waking up or changing head position⁴.
- Blurred, shadowy, or flickering vision⁴.
- Double vision or diplopia⁴.
- Temporary loss or darkening of vision when coughing, sneezing, or straining⁴.
- Nausea and vomiting⁴.
- Stiff and painful neck⁴.
How is papilledema diagnosed and treated?
To diagnose papilledema, the doctor will perform a physical and eye examination to see if there is swelling on the optic disc. In addition, the doctor will also perform a visual test to determine if there is any impairment in visual function.
The doctor will also perform additional tests to find out the cause of increased intracranial pressure. Some tests that may be done are:
- MRI (magnetic resonance imaging) or CT scan (computed tomography) to see if there is a tumor, infection, bleeding, or hydrocephalus in the brain.
- Lumbar puncture or spinal tap to measure the pressure of cerebrospinal fluid (CSF) and take a sample for laboratory examination.
The treatment of papilledema depends on the cause. The goal of treatment is to reduce intracranial pressure and prevent permanent damage to the optic nerve. Some treatments that may be done are:
- Medications to reduce the production or increase the absorption of cerebrospinal fluid (CSF), such as acetazolamide or furosemide.
- Medications to treat brain or meningeal infection, such as antibiotics or antivirals.
- Surgery to remove brain tumor, blood clot, or place a shunt to drain cerebrospinal fluid (CSF) to another place.
How to prevent papilledema?
Papilledema cannot be prevented completely, because it can be caused by various factors that cannot be controlled. However, there are some things that can be done to reduce the risk of papilledema, such as:
- Maintaining brain health by consuming nutritious food, exercising regularly, not smoking, and not consuming alcohol excessively.
- Avoiding head trauma by wearing a helmet when riding or cycling, seat belt when driving a car, and head protection when playing contact sports.
- Checking with a doctor regularly if you have a history of diseases that can increase intracranial pressure, such as hypertension, diabetes mellitus, obesity, or polycystic ovary syndrome (PCOS).
Referensi:
(2)https://bing.com/search?
(3)https://www.ncbi.nlm.nih.gov/books/NBK538295/.
(4)https://www.merckmanuals.com/professional/eye-disorders/optic-nerve-disorders/papilledema.
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