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Point-of-Care Ultrasonography for the Identification of 2 Children With Optic Disc Drusen Mimicking Papilledema

Braun, Alanna MD*; Doniger, Stephanie J. MD, RDMS

doi: 10.1097/PEC.0000000000000172
Ultrasound Case Reviews

Abstract: We present 2 cases of asymptomatic patients who were found to have raised and blurred optic discs on physical examination, suggestive of papilledema. Evaluation in the emergency department revealed 2 well-appearing children with normal vital signs and neurologic evaluation results, without symptoms of increased intracranial pressure. Point-of-care ocular ultrasonography was performed on both children, demonstrating calcification at the optic nerve, which is diagnostic of optic disc drusen. Optic disc drusen is caused by the deposition of calcified axonal debris and is often buried within the optic disc in pediatric patients. It can cause some changes in visual acuity and visual fields, but patients who are otherwise asymptomatic can be easily diagnosed through point-of-care ultrasound, thereby sparing patients an aggressive workup if their clinical picture is otherwise reassuring.

From the *Pediatric Residency Program and †Division of Emergency Medicine, UCSF Benioff Children’s Hospital Oakland, Oakland, CA.

Disclosure: The authors declare no conflict of interest.

Corresponding author: Stephanie J. Doniger, MD, RDMS, FAAP, FACEP, Division of Emergency Medicine, UCSF Benioff Children’s Hospital Oakland, 747 52nd St, Oakland, CA 94609.

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© 2014 Lippincott Williams & Wilkins, Inc.