During fundoscopy of a patient with suspected papilloedema, spontaneous venous pulsation is clearly visible at the optic disc. How should this finding be interpreted?

• A It confirms raised intracranial pressure
• B It is present in almost all patients with papilloedema
• C It indicates central retinal vein occlusion
• D Its presence argues against significant raised intracranial pressure, though it does not exclude it entirely ✓

Explanation

Spontaneous venous pulsation is present in roughly 80 percent of normal individuals and disappears when intracranial pressure rises above venous pressure. Therefore its presence is reassuring evidence against active papilloedema, although about 20 percent of normal people lack it, so its absence proves nothing. It is not a feature of central retinal vein occlusion, which shows diffuse haemorrhages.

Reference: Kanski's Clinical Ophthalmology, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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