A patient with known Foster Kennedy syndrome will show which classic combination on fundoscopy?
- A Bilateral disc edema with macular star
- B Bilateral optic atrophy with central scotoma
- C Ipsilateral optic atrophy and contralateral papilledema due to frontal lobe mass ✓
- D Ipsilateral papilledema and contralateral optic atrophy
Correct answer: C. Ipsilateral optic atrophy and contralateral papilledema due to frontal lobe mass
Explanation
Foster Kennedy syndrome is caused by a space-occupying lesion (classically an olfactory groove meningioma or frontal lobe tumor) that directly compresses the ipsilateral optic nerve, causing optic atrophy on that side (from direct compression), while simultaneously raising intracranial pressure, which causes papilledema in the contralateral (unaffected) eye. The ipsilateral side shows atrophy because the disc is unable to swell due to pre-existing atrophy — this is called 'pseudo-Foster Kennedy syndrome' when bilateral sequential optic neuritis mimics this appearance.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
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Written and medically reviewed by the StethoPrep medical team.