I agree with that. I now have two cases of pseudopapilledema referred by optometrists I think, at least one of them was, that were followed with rock solid identical photographs for years and then blew up into real papilledema. I found it disquieting - how many of these pseudopapilledcemas are mild real papilledema? I don’t really think so for mine at least since there was zero fluctuation and they were hyperopic and no vision loss or other symptoms, and when they blew up they had symptoms. I think a contributing factor for such a situation being not uncommon is that many of these patients are referred because they are heavy, on top of a somewhat suspicious nerve, and these are the demographic that can go on to have IIH of course.
Original Message:
Sent: 6/18/2026 10:05:00 AM
From: Sherif Ahmed Kamel Abdelbar
Subject: RE: Papilledema
This could be a pseudo papilledema on top of true papilledema due gliosis , this may lead to erroneous decisions as regards falsely non resolving papilledema , here the disc elevation must not be the only denominator of presence of active disease so a case like this in the follow up the whole examination must be repeated including history and symptomatology comparison from the last visit and of course repeating the visual fields , Frisen 2 may be problematic in follow up than higher grades