What is a characteristic early sign of papilloedema?

Papilledema is characterized by swelling of the optic disc due to increased intracranial pressure. One key early sign of this condition is the presence of a hyperemic and elevated disc margin. This hyperemia indicates that there is an increased blood flow to the optic nerve head, which can lead to the disc appearing swollen and having a blurred margin. This is distinct from normal findings in the optic disc and suggests that there is a pathological process at work.

In the context of papilledema, the elevated disc margin signifies that the edema is affecting the structure of the optic nerve head, resulting in the characteristic appearance observed during an ophthalmic examination. Recognizing this change is crucial as it can indicate an underlying issue, such as a brain tumor, hemorrhage, or other causes of increased intracranial pressure that requires prompt medical attention.

Other options, such as unilateral disc swelling, would not be characteristic of bilateral papilledema typically seen in increased intracranial pressure, while absent disc capillaries and distal retinal veins are not primary indicators of papilledema. Therefore, detecting a hyperemic and elevated disc margin is a significant early sign in diagnosing and managing this condition effectively.