Congenital Optic Disc Drusen Misdiagnosed As Benign Idiopathic Intracranial Hypertension

Abstract

A 16 year old female, was referred by the neuro-physician for the evaluation and management of decrease visual acuity in the left eye and papilledema, she was diagnosed Benign Idiopathic Intracranial Hypertension. She was under treatment for 4 years for papilledema. Visual acuity was 6/6 in the right eye and 1/60 in the left eye. Slit lamp examination was normal. Fundoscopy showed lumpy appearances of the optic nerve heads with vessels and macula normal, in both eyes. Her B scan ultrasonography and Computerized Tomography scan were carried out that revealed buried optic disc drusen a cause of pseudo-papilledema. On General examination she had typical Cushingoid features that she developed due to excess steroid therapy she was prescribed.This casehighlights the importance of identifying buried optic disc drusen, being misdiagnosed and treated as true papilledema secondary to Benign Idiopathic Intracranial Hypertension.