When a patient presents with symptoms suggestive of papilledema, an ophthalmologist conducts a comprehensive eye examination. Using an ophthalmoscope, the physician directly visualizes the optic nerve head, the anterior portion of the optic nerve at the back of the eye. Normally, this structure, typically slightly over 1.5 millimeters in diameter, presents with sharp, distinct margins and a mild central depression, known as the optic disc. Papilledema is diagnosed when the optic disc appears elevated, and its outer boundaries are blurred or indistinct. This condition arises from increased intracranial pressure (ICP), which impedes venous outflow from the retina, leading to swelling of the optic nerve head. Ophthalmoscopic signs include engorged retinal veins, absence of spontaneous venous pulsations, and in severe cases, peripapillary hemorrhages or exudates on the retina. Papilledema due to elevated ICP is typically bilateral. Visual field defects, such as an enlarged blind spot and constricted peripheral vision, are common. Visual field testing can range from a bedside confrontation exam to a more formal evaluation using specialized grids by an ophthalmologist. While papilledema caused by increased brain pressure generally does not cause permanent optic nerve damage unless prolonged, the primary concern is the underlying brain pathology, as cerebral swelling can be life-threatening. Emergency brain imaging (Computed Tomography or Magnetic Resonance Imaging) is crucial to identify any structural abnormalities. If brain imaging is normal, a lumbar puncture is often performed to measure cerebrospinal fluid pressure. Idiopathic Intracranial Hypertension (pseudotumor cerebri) is a common cause of papilledema when brain imaging results are unremarkable.