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24-year-old woman was seen in the office on 2/23/2010. She has had noticed positional blurring of her vision when she bends over since around November. When she bends over and stands up straight, she notices her vision is blurred. It is difficult to say whether it is one eye or both eyes. She has been anemic for some time and takes a hormone pill. She is also taking Naprosyn, acetaminophen and vitamins. VISUAL ACUITY: Vision OD is 20/100, PH 20/40; OS is 20/80, PH 20/30. IOP: 19 OU. AMSLER GRID: Normal in both eyes. SLIT LAMP EXAM: Normal with clear lenses. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.0. There is 4+ optic nerve swelling with dilation of the retinal vessels all around the optic nerve. OS: Vertical C/D ratio is 0.0. There is 2+ optic nerve swelling. IMPRESSION: 1. PAPILLEDEMA – BOTH EYES 2. PROBABLE INCREASED INTRACRANIAL PRESSURE DISCUSSION: I explained to the patient the positional blurred vision is typical of patients with advanced papilledema. It looks, especially in the right eye, that there may have been damage to the eye that may cause visual field loss. I am going to discuss with you the possibility of having visual field testing on her, which needs to track the course of her optic nerve pathology. In addition, I have spoken with her doctor who has agreed to see the patient within the week for further evaluation so the etiology of the papilledema can be determined and treatment can be initiated. Vision improved to 20/25 after spinal tap

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Papilledema from pseudotumor cerebri Pre Spinal Tap - VA 20/100312 views24-year-old woman was seen in the office on 2/23/2010. She has had noticed positional blurring of her vision when she bends over since around November. When she bends over and stands up straight, she notices her vision is blurred. Vision OD is 20/100, PH 20/40; OS is 20/80, PH 20/30. IOP: 19 OU.
vision was 20/25 after tap
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Papilledema from pseudotumor cerebri Pre Spinal Tap - VA 20/100167 views24-year-old woman was seen in the office on 2/23/2010. She has had noticed positional blurring of her vision when she bends over since around November. When she bends over and stands up straight, she notices her vision is blurred. Vision OD is 20/100, PH 20/40; OS is 20/80, PH 20/30. IOP: 19 OU.
vision was 20/25 after tap
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Papilledema post-spinal tap va 20/25283 views24-year-old woman was seen in the office on 2/23/2010. She has had noticed positional blurring of her vision when she bends over since around November. When she bends over and stands up straight, she notices her vision is blurred. Vision OD is 20/100, PH 20/40; OS is 20/80, PH 20/30. IOP: 19 OU.
vision was 20/25 after tap
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Papilledema post-spinal tap va 20/25244 views24-year-old woman was seen in the office on 2/23/2010. She has had noticed positional blurring of her vision when she bends over since around November. When she bends over and stands up straight, she notices her vision is blurred. Vision OD is 20/100, PH 20/40; OS is 20/80, PH 20/30. IOP: 19 OU.
vision was 20/25 after tap
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24-year-old woman was seen in the office on 2/23/2010. She has had noticed positional blurring of her vision when she bends over since around November. When she bends over and stands up straight, she notices her vision is blurred. It is difficult to say whether it is one eye or both eyes. She has been anemic for some time and takes a hormone pill. She is also taking Naprosyn, acetaminophen and vitamins. VISUAL ACUITY: Vision OD is 20/100, PH 20/40; OS is 20/80, PH 20/30. IOP: 19 OU. AMSLER GRID: Normal in both eyes. SLIT LAMP EXAM: Normal with clear lenses. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.0. There is 4+ optic nerve swelling with dilation of the retinal vessels all around the optic nerve. OS: Vertical C/D ratio is 0.0. There is 2+ optic nerve swelling. IMPRESSION: 1. PAPILLEDEMA – BOTH EYES 2. PROBABLE INCREASED INTRACRANIAL PRESSURE DISCUSSION: I explained to the patient the positional blurred vision is typical of patients with advanced papilledema. It looks, especially in the right eye, that there may have been damage to the eye that may cause visual field loss. I am going to discuss with you the possibility of having visual field testing on her, which needs to track the course of her optic nerve pathology. In addition, I have spoken with her doctor who has agreed to see the patient within the week for further evaluation so the etiology of the papilledema can be determined and treatment can be initiated. Vision improved to 20/25 after spinal tap