Visual loss in idiopathic intracranial hypertension after resolution of papilledema

Purpose: To demonstrate that progressive visual field loss may occur after resolution of papilledema in patients with idiopathic intracranial hyperten sion and persistently elevated intracranial pressure. Methods: A patient with idiopathic intracranial hypertension was evaluated with serial Humphrey automated static perimetry after initial treatment and resolution of papilledema. Results: The patient developed recurrent headache and elevated cerebrospina l fluid pressure. Optic nerve head appearance did not change. Automated per imetry demonstrated reproducible, worsening visual field loss; mean deviati on decreased 11 dB in each eye. Visual field defects resolved after optic n erve sheath fenestration. Conclusions: Increased intracranial pressure caused visual field loss after resolution of papilledema. Optic nerve sheath fenestration improved visual function in this patient.