What is the Difference Between Papillitis and Papilloedema

The key difference between papillitis and papilloedema is that papillitis is the inflammation and deterioration of the optic nerve head or optic disk, while papilloedema is the swelling of the optic nerve head or optic disc due to increased intracranial pressure.

Optic neuritis occurs when swelling and inflammation damage the optic nerve. The optic nerve is a bundle of nerve fibers that transmits visual information from the eye to the brain. The common symptoms involved in this condition include pain and temporary loss of vision in one eye. Papillitis and papilloedema are two types of optic neuritis.

CONTENTS

1. Overview and Key Difference
2. What is Papillitis 
3. What is Papilloedema
4. Similarities – Papillitis and Papilloedema
5. Papillitis vs Papilloedema in Tabular Form
6. Summary – Papillitis vs Papilloedema

What is Papillitis?

Papillitis is the inflammation and infarction of the optic nerve head. It is also referred to as a blind spot. The optic nerve head or disc is the portion of the nerve that enters the eye and joins with the nerve-rich membrane lining the eye. This nerve-rich membrane lining is called the retina. The optic nerves are the pair of nerves that normally transmit impulses from the retina to the brain. Papillitis may occur due to unknown reasons, viral or bacterial illness (polio, measles, pneumonia, meningitis), or due to a number of different underlying disorders or other factors (damages to the nerve lining by multiple sclerosis and encephalomyelitis, nutritional or metabolic disorders such as diabetes, pernicious anemia, hyperthyroidism, secondary complications of other diseases, reactions to toxic substances such as methanol, quinine, salicylates, arsenic, etc. trauma and temporal arteritis).

The sign and symptoms of papillitis include unilateral loss of vision, pain in the eye, and interference with accurate colour vision (dyschromatopsia). In some cases, spontaneous recovery can occur. However, in other cases, permanent visual impairment can occur if the underlying cause is not detected. Moreover, papillitis can be diagnosed by testing visual acuity, testing colour vision, examination of the optic disc by ophthalmoscopy and magnetic resonance imaging. Furthermore, treatment options for papillitis include corticosteroid drugs such as prednisone or methylprednisolone and symptomatic and supportive therapy.

What is Papilloedema?

Papilloedema is the swelling of the optic nerve head or optic disc due to raised intracranial pressure. The swelling in the papilloedema is usually bilateral and can occur over a period of hours to weeks. The causes of papilloedema include smoking, brain tumor, respiratory failure, hypotonia, isotretinoin, medications like tetracycline, hyperammonemia, Guillain-Barre syndrome, POEMS syndrome, Foster-Kennedy syndrome, Chiari malformation, tumors of the frontal lobe, acute mountain sickness, Lyme disease, medulloblastoma, obesity, acute lymphocytic leukemia, and CPAP therapy for sleep apnea.

The sign and symptoms of papilloedema include venous engorgement, loss of venous pulsation, haemorrhages over the optic discs, blurring of the optic margins, the elevation of the optic disc, Paton’s lines, headache, enlargement of the blind spot, blurring vision and obscurations. Moreover, papilloedema can be diagnosed through clinical evaluation, ophthalmoscopy or fundus photography, and slit lamp examination. Furthermore, papilloedema is treated through medications to reduce diuretics like acetazolamide and furosemide, steroids, lumbar punctures to remove excess spinal fluids in the cranium, and treating underlying conditions.

What are the Similarities Between Papillitis and Papilloedema?

• Papillitis and papilloedema are two types of optic neuritis.
• Both conditions are due to problems in the optic nerve head or optic disk.
• They can cause complete vision loss.
• Both conditions can be diagnosed through ophthalmoscopy.
• They can be treated through medications like steroids.

What is the Difference Between Papillitis and Papilloedema?

Papillitis is the inflammation and deterioration of the optic nerve head or optic disk, while papilloedema is the swelling of the optic nerve head or optic disc due to raised intracranial pressure. Thus, this is the key difference between papillitis and papilloedema. Furthermore, papillitis causes sudden vision loss, whereas papilloedema causes gradual vision loss.

The below infographic presents the differences between papillitis and papilloedema in tabular form for side-by-side comparison.

Summary – Papillitis vs Papilloedema

Papillitis and papilloedema are two types of optic neuritis that can lead to complete vision loss if they are not treated properly. In papillitis, inflammation and deterioration of the optic nerve head or optic disk take place. In papilloedema, swelling of the optic nerve head or optic disc occurs due to increased intracranial pressure. So, this is the key difference between papillitis and papilloedema.

Reference:

1. “Papilledema.” An Overview | ScienceDirect Topics.
2. “Papillitis.” NORD (National Organization for Rare Disorders).

Image Courtesy:

1. “Optic-neuritis-in-the-right-eye” By Pratik Y. Gogri, Somen L. Misra, Raghunandan N. Kothari, Akshay J. Bhandari, Hitesh V. Gidwani – Pratik Y. Gogri et. al. “Ophthalmic Manifestations of HIV Patients in a Rural Area of Western Maharashtra, India”, International Scholarly Research Notices doi:10.1155/2014/347638 (CC BY 4.0) via Commons Wikimedia
2. “Papilledema” By Jonathan Trobe, M.D. – University of Michigan Kellogg Eye Center – The Eyes Have It (CC BY 3.0) via Commons Wikimedia