Walsh & Hoyt: Papilledema: Visual Prognosis

Establishing the visual prognosis in a patient with papilledema is often impossible. Generally, the more severe the papilledema, the worse the visual prognosis. An ominous sign is narrowing of the retinal arteries, which often occurs with sheathing. In this setting, irreversible damage to the optic nerve tissue has already occurred, as is the case when there is loss of the peripapillary retinal nerve fiber layer