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Distinguish congenital from acquired optic disc elevation
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Trap:
ophthalmoscopy may not be reliable in this task
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Tip:
optical coherence tomography, ultrasound, autofluorescence photography, and orbit CT are useful in disclosing buried drusen
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Tip:
ancillary imaging is not yet reliable in distinguishing papilledema from other causes of acquired optic disc elevation
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If you have excluded congenital optic disc elevation, use these clues to determine the cause of acquired optic disc elevation
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Symmetrical elevation in the two eyes and absence of major visual dysfunction suggests papilledema
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Segmental elevation of the optic disc suggests non-arteritic infarction
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Pallid elevation suggests arteritic infarction
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Tip:
in the absence of these signs, use non-ophthalmoscopic information to diagnose the cause of acquired optic disc elevation