Papilloedema associated with dural venous sinus thrombosis

Papilloedema is a diagnostic term used exclusively to describe optic disc oedema associated with increased intracranial pressure. Septic cerebral venous sinus thrombosis has become an increasingly rare cause of papilloedema because of the widespread availability of antimicrobial agents; however, it is imperative for optometrists to maintain vigilance for this pathologic process. Presented is a case of a 77-year-old Caucasian male with a complaint of blurred vision and non-specific, diffuse headache. He had a right sixth cranial nerve palsy and bilateral disc oedema. Raised intracranial pressure was confirmed by lumbar puncture. Neuroimaging, including magnetic resonance imaging and magnetic resonance venography in conjunction with cytological assessment of the cerebral spinal fluid led to a probable diagnosis of mastoiditis causing multiple dural venous sinus thrombi of the superior sagittal and right transverse sinuses. Sequential evaluation of this complex case is displayed along with pertinent differential diagnoses for optic disc oedema and a review of current standards for diagnosis and management of papilloedema from dural sinus thrombosis.